Mitral Regurgitation Flashcards
1
Q
What is mitral regurgitation?
A
Failure of the mitral valve to prevent backflow of blood into the left atrium during systole.
2
Q
What can cause mitral regurgitation?
A
- Idiopathic weakening with age
- Ischaemic heart disease
- Infective endocarditis
- Rheumatic fever
- Connective tissue disorders
3
Q
What organism causes rheumatic fever?
A
Group A beta-haemolytic strep (Strep pyogenes)
4
Q
Simplify the pathogenesis of MR.
A
- Valve too floppy e.g. connective tissue disorders
- Ring stretched too wide e.g. cardiomyopathy
5
Q
How does MR present?
A
- Usually asymptomatic to a point
- Dyspnoea on exertion
- Fatigue and dizziness, reduced exercise tolerance
- Chest pain
- Palpatations
6
Q
What murmur does it cause and where?
A
- Pan-systolic murmur
- 5th ICS mid-clavicular
- Radiates to axilla when leaning to L
7
Q
What happens to S1 and S2?
A
S1 is soft, S2 is split
8
Q
What else may be found in the chest?
A
- Displaced left, volume-loaded (forceful) apex beat
9
Q
What investigation is gold standard?
A
ECHO- flow studies and structural abnormality
10
Q
What other imaging may be used?
A
- CXR- oedema, valve calcification (rheum fev)
- Cardiac catheterisation
11
Q
What might and ECG show?
A
- Arrhythmia
- P mitrale (camel hump P wave)
12
Q
Name three complications of MR.
A
- AF- atria contract at different rates (left side is slower due to hypertrophy)
- Pulmonary HTN and cor pulmonale
- HFrEF
