mitral regurgitation Flashcards
when does it occur
abnormalities of the valve leaflets, the annulus, the chordae tendineae or papillary muscle
most frequent causes
- degenerative disease
- ischaemic heart disease
- rheumatic heart disease
- infectious endocarditis
other causes
- diseases of myocardium
- rheumatic autoimmune diseae
- collagen disease (Marfans)
- disorders caused by drugs
what does regurgitation into the left atrium produce
left atrial dilatation
what JVP wave can be seen
v wave
what happens to stroke volume
increase
symptoms
- palpitation
- SOB
- orthopnoea
- fatigue
- cardiac cachexia
signs
- laterally displaced apex
- systolic thrill
- pansystolic murmur
- mid-systolic click
- S3
why is there S3
sudden rush of blood back into the dilated left ventricle in early diastole
what is done to diagnose
- CXR
- ECG
- echo
- cardiac Catheterisation
what is seen on CXR
- left atrial and left ventricle enlargement
- valve calcification
what is seen on ECG
- bifid p wave
- left ventricular hypertrophy (tall R wave in V1)
- AF
what does bifid p wave mean
left atrial delay
what is seen on echo
- dilated left atrium and left ventricle
- chordal or papillary muscle rupture
- structural valve abnormalities
how is severity of regurgitation assessed
colour Doppler
what is seen on cardiac catheterisation
- prominent left atrial systolic pressure wave
treatment of mild regurgitation with no symptoms
conservative
give patient echos
treatment when there is cardiac enlargement
surgical intervention by either mitral valve repair or replacement
treatment if symptomatic
surgical intervention
treatment if patient has AF
surgical intervention
when is surgical intervention less beneficial
late stage in disease
what is treatment when patients are not suited for surgery or disease is late staged
- diuretics
- ACE inhibitors
- anticoagulants
