Cardio: Mitral Valve Prolapse Flashcards
Other names for MVP
Systolic click murmur syndrome
Barlow’s syndrome
Floppy valve syndrome
Billowing mitral leaflet syndrome
MVP is caused by decrease in type ___ Collagen production
III
Heritable disorders that might cause MVP (3)
Marfan
OI
Ehler Danlos
Leaflet that’s most frequently affected with MVP
posterior leaflet
mitral valve annulus is often
a. dilated
b. constricted
A
What is the most common abnormality leading to primary mitral regurgitation
MVP
MVP is more common in
A. men
B. women
B
Most common age for mvp
15-30 yrs.
In __ y.o. ___, MVP is more severe requires surgery
a. 50, men
b. 40, men
c. 50, women
d. 40, women
A
Auscultation findings in MVP
Systolic click and mid to late systolic murmur
T/F Most patients with MVP are asymptomatic forever
T
Cause of palpitations and lightheadedness in MVP
AF
True about MVP murmur EXCEPT
a. 0.14s or more after S1
b. mid to late systolic crescendo-decrescendo murmur
c. “whooping” or “hanking”
d. heard best at apex
A; this is for systolic click
Strain / valsalva will _______ the click and murmur
a. intensify
b. decrease
A
Squatting/ isometric exercise will _______ the click and murmur
a. intensify
b. decrease
B
systolic displacement of the belly of the mitral valve leaflets by at least __mm into the L atrium superior to the plane of the mitral annulus
2
Echocardiogram definition of MVP
systolic displacement of the belly of the mitral valve leaflets by at least 2mm into the L atrium superior to the plane of the mitral annulus
Transesophageal echocardiogram is indicated when:
more accurate anatomic information is required and is performed routinely for intra-op guidance during valve repair
EXERCISE TESTING indication
performed when there is uncertainty regarding functional capacity
T/F
Invasive L ventriculogrpahy done at time of R and L heart catheterization is necessary
rarely necessary but can show prolapse
Scoring system that estimate risk of ischemic stroke in px with non-rheumatic nonvalvular Atrial Fibrillation
CHA2DS2VASc Scoring
What CHA2DS2VASc Score would signify likely to benefit from anticoagulation?
men: 1 or more
women: 2 or more
meaning of CHA2DS2VASc and points
CHF/LV dysfunction Hypertension Age >75 y.o. Diabetes Mellitus Stroke/TIA/Thromboembolism Vascular Disease Age 65-74 y.o. Sc Female Sex 1 point each except age >75 y.o. and Stroke; 2 points
T of MVP tx EXCEPT
A. Infective endocarditis is indicated for patients with prior history of endocarditis
B. Mitral valve replacement is preferred over repair
C. For surgical planning, TEE imaging is helpful
D. Trancatheter edge-edge repair is done for treatment of symptomatic patient with high surgical risk.
B
