Mitral Stenosis Flashcards
What are the main causes of mitral stenosis?
- Rheumatic fever
- Congenital (rare): Lupus, carcinoid, rheumatoid arthritis, age-related calcification (MAC)
Which annulus is most commonly involved in MAC?
Posterior
MAC usually occurs in patients with what other diseases?
- Fibroelastic deficiency of MV
- Systemic hypertension
- Metabolic diseases such as diabetes, hypercalcemia, renal dialysis
In what window do we assess MAC? What are the severities?
PSAX
Mild: less than 1/3 of the mitral valve
Mod: up to 2/3
Severe: more than 2/3
What are the main features of the MV with rheumatic disease?
- Bowing or doming of the leaflets in diastole (hockey stick appearance)
- Commissural fusion of the left and right cusps
- Cord thickening and fusion
- LA enlargement
When there is a faster rise in LV diastolic pressure due to MS in the presence of Ao regurgitation, what happens to the half-time?
It is shorter because it takes LESS time for the pressure to rise as blood is flowing back into the LV
When is using the pressure half time method calculation useful as well as not useful?
Useful in mild-mod Ao regurgitation
Not useful with severe Ao regurgitation
What is a common site of thrombus formation due to mitral stenosis?
Left atrial appendage
How are pulmonary pressures measured?
Tricuspid regurgitation jet
Pressure gradient in MS declines slowly, so what happens to the pressure half time?
Pressure half time will be longer because it declines slower
In Mitral stenosis, is there a longer of shorter pressure half time?
Longer PHT due to pressure gradient slowly declining
What is the most common cause of pulmonic stenosis?
Congenital disease
T or F? Calcification of the valve is rare in pulmonic stenosis?
TRUE
What views are the best to assess RV hypertrophy?
PLAX
Subcostal 4 chamber
What is the abnormal measurement for the thickness of the RV free wall?
> 5mm
