Blonder - Chronic Mitral Regurgitation Flashcards
What is the most elusive component of the pathophysiology of mitral valve regurgitation?
The transition from compensated to decompensated
Should the EF in a pt with mitral regurg be low, normal, or high?
EF should be normal or high due to increased preload from regurgitant valve
Decrease in EF is a major cause for alarm
What are the five components of the mitral valve?
Valve leaflets
Mitral annulus
L atrium
Chordae tendinae
L ventricle
What is the most common cause of mitral regurgitation?
Myxomatous degeneration of mitral valve
Besides myxomatous degeneration, what are two other causes of mitral regurgitation that affect the leaflets?
Rheumatic changes
Subacute bacterial endocarditis
What change(s) to the mitral annulus can cause mitral regurgitation?
Calcification
usually not severe
practically impossible to repair surgically
What changes to the chordae tendinae can cause mitral regurgitation?
Rupture (usually an acute cause)
Rheumatic fever will fix chordae
Bacterial endocarditis (usually acute)
What changes to the L atrium can cause mitral regurgitaiton?
Dilation of the L atrium
Mitral regurg will cause this dilation, making the regurg worse
What are two very good clues of decompensated heart failure?
Orthopnea
Paroxysmal nocturnal dyspnea
What is the character of the sound of mitral regurgitation?
Blowing holosystolic murmur
What is the medical treatment for mitral regurg?
Lower systemic vascular resistance so blood goes where it’s supposed to go
