Mitral Regurgitation Flashcards
1
Q
What will be heard on auscultation of mitral reg.?
A
- Two bit S2 sound
2
Q
Where is the murmur loudest?
A
- Apex
3
Q
What increases the regurgitated volume during mitral reg.?
A
- Annular enlargement of preload/afterload/contractility
4
Q
What happens to the heart in chronic mitral reg.?
A
- LVH
5
Q
Acute symptoms?
A
- Dyspnoea
- Cardiogenic shock
6
Q
Chronic symptoms?
A
- Fatigue
- Exhaustion from low cardiac output
7
Q
Signs?
A
- Right heart failure
- Pulmonary oedema
- Dyspnoea and use of accessory muscles
- Palpitations (AF)
- Reduced pulse
- Prominent JVP IF RH failure
- Quick apex beat
- RV heave
- Reduced S1
- Split S2
8
Q
How do you hear the murmur?
A
- It radiates from apex to axilla
- Maximal on exertion
9
Q
Causes?
A
- Rheumatic heart disease
- Mitral valve prolapse
- Infective endocarditis
- Degenerative
10
Q
Initial investigations?
A
- ECG
- CxR
- Cardiac catheterisation
- Echocardiogram
11
Q
What will be found on the ECG?
A
- P wave longer than 0.12s
- Tall prominent R wave in precordial leads
12
Q
What will be seen on CxR?
A
- Cardiomegaly
- LA enlargement
- Calcification of mitral annulus
13
Q
What will be seen on echocardiogram?
A
- LV dimensions
- Look for leaflet disease
- Chordae or papillary muscle issues
- Severity of regurg
14
Q
Treatment?
A
- Sodium nitroprusside
- Dobutamine
15
Q
What do sodium nitroprusside and dobutamine do?
A
- Reduce preload and afterload
