Mitral Regurgitation Flashcards
Definition
ejection of portion of LV SV backward into LA due to insufficiency of mitral valve
epidemiology
- -middle-aged white Americans
- -incidence increases w/ age
- -usually equal in men and women, though women’s less severe?
Most common cause
mitral valve prolapse (2/3 of cases)
second most common cause
ischemic heart disease (1/4 of cases)
Consequences
- decreased forward SV
- increased LA volume and pressure
- volume-related stress on LV b/c added LA volume is returned to it along w/ normal LA volume during diastole
If MR is acute…
LA pressure is raised
If MR is chronic..
LA dilatation allows it to hold extra volume w/ less elevated pressure
If rupture of papillary muscle (due to MI or IE) causes sudden MR…
resulting increased LA pressure, transmitted backward to pulmonary circulation, may cause rapid pulmonary congestion and edema
“flash pulmonary edema”
“flash pulmonary edema”
medical emergency
rupture of papillary muscle (due to MI or IE) causes sudden MR resulting increased LA pressure, transmitted backward to pulmonary circulation, causing rapid pulmonary congestion and edema
If slowly developing MR…
- -LA dilates
- -increasing proportion of SV goes backward into low pressure instead of high pressure aorta
symptom of acute MR
dyspnea
most common symptom of chronic MR
fatigue
severe– leading to HF– will cause PND and orthopnea
sign
apical holosystolic (pansystolic) murmur
in severe chronic, may also have ventricular gallop
apical holosystolic (pansystolic) murmur
sometimes has harsh quality
in severe acute MR…may be decrescendo (b/c rapid equilibration b/w left arial and ventricular ressures during systole)
25% reduction of forward stroke volume (100mL to 75mL) is associated w/…
clinical manifestations of HF
