Mitral stenosis Flashcards
What is the pathophysiology of mitral stenosis?
Increased pressure due to obstruction from the left atrium to the left ventricle leading to left atrial pressure increases and elevation in pulmonary pressures.
What is the most common risk factor for development of mitral stenosis?
rheumatic heart disease following a period of 10-20 years after the initial episode of rheumatic fever following infection with group A streptococcus.
Why is pregnancy a high risk condition with mitral stenosis?
Pregnant women with MS are at risk for atrial fibrillation and pulmonary edema due to physiologic hypervolemia and increased left atrial and pulmonary venous pressure.
What clinical symptoms are associated with mitral stenosis due to increased pulmonary pressures?
Exertional Dyspnea (shortness of breath with exercise), decreased exercise tolerance, coughing up blood (hemoptysis).
why does mitral stenosis lead to right ventricular hypertrophy?
chronic elevated pulmonary pressure leads to fibrosis, requiring the right ventricle to work harder to pump blood into the pulmonic circulation. Eventually right axis deviation from right ventricular hypertrophy causes right high failure.
What EKG findings are associated with right ventricular hypertrophy?
peaked R-waves in V1 and V2
What are the clinical symptoms secondary to right ventricular heart failure secondary to mitral stenosis?
Mitral facies (pinkish-purple patches on cheeks), paroxysmal nocturnal dyspnea, orthopnea, and JVD. Advanced disease may lead to edema, pleural effusions, and hepatic congestion.
What EKG finding is commonly associated with mitral stenosis?
p-mitrale; this is a biphasic (double) p-wave which follows left atrial enlargement, “broad-notched p-wave.”
What the clinical symptom is common due to mitral stenosis secondary to atrial enlargement?
voice hoarseness due to compression of the recurrent laryngeal nerve (Ortner syndrome).
Why does hemoptysis occur in mitral stenosis?
brachial artery erosion.
What arrhythmia is associated with mitral stenosis?
atrial fibrillation
What murmur is associated with mitral stenosis?
Opening snap followed by a low-pitched mid-diastolic rumble.
Where is mitral stenosis best heard?
at the apex.
Describe the S1 in mitral stenosis?
“loud FIRST heart sound”
Describe the P2 in mitral stenosis
Also loud!
What is the method of diagnosing mitral stenosis?
CXR, EKG, Echo (transthoracic)
