10. Valvular Disease Flashcards
What is mitral regurgitation?
back flow through the mitral valve during systole
What can cause mitral regurgitation?
functional (LV dilation) annular calcification (elderly) Rheumatic fever infective endocarditis cardiomyopathy congenital connective tissue disorders (post MI)
What are the signs and symtoms of mitral regurgitiation?
Pan-systolic murmur radiating to the axilla
Dyspnoea, fatigue, palpitations
AF, displaced apex
What tests can be done for mitral regurgitation?
ECHO- best to assess LV function + severity/aetiology
ECG
CXR
How do you manage mitral regurgitiation?
Control rate and aniticoagulate if AF
anti coagulate if history of embolism
Diuretics improve symptoms
Surgery for deteriorating symptoms/ before LV is compromised
What is the most common valvular disease?
What causes it?
Mitral valve prolapse
Autism, , PDA, Cardiomyopathy, turners, marfans,
What are the signs of mitral valve prolapse?
What are the complications of a mitral valve prolapse?
Usually asymptomatic. Late systolic murmur
Cerebral emboli
Arrythmias
Sudden death
How do you treat severe mitral valve disease?
B blockers to help palpitations/chest pain
Surgery if severe MI
Explain the pathology of mitral stenosis?
Mitral valve becomes stenosed meaning less blood can come through.
This leads to pulmonary hypertension, enlarged left atrium, fatigue,
What are the signs of mitral stenosis?
Pressure symptoms (Hoarse voice, dysphagia)
Malar flush
RV heave, mid diastolic murmur
How is mitral stenosis treated?
If AF- rate control,
Anti-coagulate
Diuretics
If this does not control symptoms then balloon valvuplasty
What is the Japanese octopus pot disease called?
Takatsubo cardiomyopathy
How does aortic stenosis present?
Classic triad of angina, syncope and HF
may also have dyspnoea, syncope,
ejection systolic murmur that radiates to the carotids
How is aortic stenosis managed?
Surgery- poor survival without it
usually valve replacement
What is aortic sclerosis?
Senile degeneration of the valve
Ejection systolic murmur but no radiation
What are the acute causes of aortic regurgitation?
Infective endocarditis
Ascending aortic dissection
Chest trauma
What are the chronic causes of aortic regurgitation
Congenital Connective tissue disorders (marfans) Rheumatic fever Arteritis RA
What are the symptoms and signs of aortic regurgitation?
Exertional dyspnoea
Orthopnoea
Paroxysmal nocturnal dyspnoea
Early diastolic murmur heard best when sitting forward
What is the treatment of aortic regurgitation?
Reduce systolic hypertension
Only surgery when severe AR with enlarged ascending aorta
Explain the presentation of tricuspid regurgitation?
Typically caused by RF, Infective endocarditits, congenital
Leads to a v heave, hepatic pain (due to congestion)
pansystolic murmur heard at the lower left sternal edge
How do you manage tricuspid regurgitation?
Diuretics for systemic congestion
Valve repair of replacement
Explain the presentation of tricsupid stenosis?
Typically RF may be infective endocarditits/congenital
fatigue, ascites, oedema, early diastolic murmur
How do you treat tricuspid stenosis
Diuretics, surgery
Explain the presentation of pulmonary stenosis
Typically a congeital condition presents with dspnoea, fatigue ascites
may be ejectio systolic murmur
