Cardiac Valve Dx Flashcards
Rheumatic heart dx -> see other class
Main cause of mitral stenosis
Rheumatic
Calcification in older people
Parhogenesis of mitral stenosis
mitral valve orifice diminished by progressive fibrosis, calcification of valve leaflets, fusion of the cusps and subvalvular apparatu -> left ventricular filling more dependent on left atrial contraction -> dilatation and hypertrophy of LA -> left atrial pressure rise-> pulmonary venous congestion and breathlessness
Type of arrhythmia common in mitral stenosis
Atrial fibrillation
Clinical Features of mitral stenosis
Efforts related to dyspnea
Hemoptysis
fatigue,
thromboembolism
Loud S1
Tapping apex beat
Low pitched mid diastolic murmur
Thrill possible
Investigation mitral stenosis
Doppler echocardiography
Cardiac catheterization
ECG for AF , p waves when LA hypertrophy
Mitral stenosis management
Medications - anticoagulants, digoxin , beta blockers
Balloon valvuloplasty
Valve replacement
Main cause of mitral regurgitation
Rheumatic disease
Pathophysiology of mitral regurgitation
Chronic mitral regurgitation -> gradual dilatation of the LA -> LV dilates slowly-> LV diastolic and LA pressures increase
Causes of mitral regurgitation
• Mitral valve prolapse
• Dilatation of the left ventricle and mitral valve ring (e.g. coronary artery disease, cardiomyopathy)
• Damage to valve cusps and chordae (e.g. rheumatic heart disease, endocarditis)
• Ischaemia or infarction of the papillary muscle
• Myocardial infarction
Mitral regurgitation clinical features
depends on underlying cause
Apical pansystolic murmur radiate into axilla, possible thrill
Soft s1, Loud 3rd heart sound
Displaced apex
Clinical feature
Symptoms
Breathlessness
Fatigue
Oedema, ascites
Palpitation
Investigations mitral regurgitation
Echocardiography
ECG
Catheterization
Management mitral regurgitation
