Clinical: Mitral Valve Disease and Rheumatic Heart Disease Flashcards
(39 cards)
1
Q
What on this chest x-ray would be positive for mitral regurge?
A
2
Q
Mitral Stenosis: PE Findings
- In Severe Pulmonary HTN/MS, and NSR, what clinical finding is usually seen, and what is the cause of this finding?
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3
Q
Fill in the black out boxes
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4
Q
In this ECG, what would indicate that this patient has mitral stenosis?
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5
Q
Mitral Regurgitation: Treatment
- In acute, severe MR
- What is the only way to save these patients, and what structures usually rupture that requires emergent surgery?
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6
Q
Mitral Stenosis: Symptoms
- What kind of HTN Mitral Stenosis patients have?
- What does this type of HTN result in?
- What happens when this type of HTN becomes severe?
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7
Q
Mitral Stenosis: PE Findings
- What happens to S1?
- Describe the “snap” heard upon auscultation.
- What causes it?
- How can the sound tell you how severe the stenosis is?
- When would you hear a murmur, and where would you hear it?
- How does this change if a patient has mixed Mitral Stenosis and Mitral Regurgitation?
A
8
Q
Mitral Regurgitation: Treatment
- In mildly symptomatic, chronic MR or nonsurgical candidates
- What type of drugs shows improvement with symptoms and slowing of progression of MR?
- When do you avoid using these types of drugs?
- What drug would you use instead?
- If a PT also has A-fib or significant mitral stenosis, what type of drugs would additionally be prescribed?
- What type of drugs shows improvement with symptoms and slowing of progression of MR?
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9
Q
Mitral Regurgitation: Treatment
- In symptomatic, chronic MR
- What is generally recommended for most patients?
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10
Q
Mitral Stenosis: Treatment
- How do you treat a patient with known Rheumatic Heart Disease?
- What do you do to prevent or treat:
- Thrombus and embolic events
- Elevated HR
- PulmonaryHTN
A
11
Q
- What is the most common cause of chronic mitral regurgitation in the United States?
- What are the usual causes of severe acute mitral regurgitation?
- What causes the acute MR seen in patients who have coronary artery disease?
A
12
Q
- What is the leading cause of mitral stenosis?
- What are some other causes (5)?
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13
Q
How can you grade mitral valve stenosis using an echocardiogram?
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14
Q
Mitral Stenosis: PE Findings
- What are the classic observational findings of severe MS
A
Mallar Flush with pinched Blue Faces
15
Q
Describe Transcatheter Mitral Valve Repair and Replacement
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16
Q
Mitral Regurgitation: Symptoms
- In Acute, Severe MR
- Pulmonary edema can develop. What conditions can arise from this?
- What kind of pulses and sounds can be heard?
A
17
Q
What are the three causes of organic mitral regurge that are most common?
A
18
Q
What findings on the X-ray are indicated of mitral stenosis?
A
- Chest radiograph showing generalized cardiac enlargement
- Left-sided heart enlargement
- Usually left atrium but can be left ventricle. This patient has both.
- Left-sided heart enlargement
- On the lateral view, the enlarged left atrium indents the esophagus
19
Q
What is cardiac cachexia?
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20
Q
What are the two causes of functional mitral regurge that she told us to remember?
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21
Q
Mitral Regurgitation: Treatment
- In symptomatic, chronic MR patients who are not surgical candidates,
- What type of drugs are the first line of treatment when patients also have ischemic heart disease or dilated CM?
- What is the recommended treatment for MR due to
- MVP
- RHD
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22
Q
Mitral Stenosis: Treatment and Outcomes
- Of the surgeries, which has the highest operative mortality percentage and which has the lowest
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23
Q
Mitral Regurgitation: Etiology
- MR results from an abnormality of one of the 5 functional components of the Mitral Valve apparatus. What are these 5 components?
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24
Q
- Of these operations, what has the highest operative mortality percentage and what has the lowest?
A
25
How does Mitral Stenosis and decreased mitral valve area affect diastolic filling of the left ventricle?
26
Mitral Stenosis: PE Findings
* What PE findings would indicate that a patient with mitral stenosis has an enlarged right ventricle?
* What happens when the right ventricle begins to fail?
27
Mitral Stenosis: Symptoms
* What are the physiological reasons for the dyspnea, fatigue, and cough symptoms associated with Mitral Stenosis?
* What kind of heart rhythm can develop, and what can this type of rhythm lead to?
28
What time of life does Rheumatic carditis peal in terms of disease symptoms?
29
Mitral Regurgitation: Symptoms
* In Chronic, Severe MR
* What symptoms do patients present with?
* What PE finding would suggest A-fib?
* What would cause the patient to have R-sided heart failure?
* What conditions would suggest R-sided heart failure?
30
Mitral Regurgitation: Pathobiology
* Where does abnormal blood flow occur?
* How does forward cardiac failure occur?
* What conditions can occur as a result of left-sided enlargement?
31
* What is the classic symptom that patients who have mitral stenosis have?
* When does this symptom usually present?
* In later stages of the disease, how does this symptom get worse?
Symptom can present at pregnancy too
32
What on this chest x-ray would be positive for mitral regurge, due to an insufficient prosthetic mitral valve?
33
In papillary muscle dysfunction that leads to acute MR
* Which artery is usually affected?
* Which wall of the heart is usually affected?
34
Mitral Regurgitation: Treatment
* In asymptomatic, chronic MR
* What action is important?
* What role do vasodilators play?
35
Mitral Stenosis: Treatment
* What are the indications for a percutaneous mitral balloon valvotomy (PMBV) and what are the indications for mitral valve replacement?
36
Mitral Regurgitation: PE Findings
* In Chronic, Severe MR
* What kind of murmur can be heard, and where?
* What can increase the intensity of this murmur and what can decrease it?
* What happens to the heart sounds
* Where is the PMI?
37
Describe the process installing a percutaneous mitral balloon valvotomy
38
What findings on this ECG would be indicative of mitral regurgitation?
39
* What does rheumatic heart disease do to the mitral valve?
* How does the damage get worse?
