Mitral Stenosis Flashcards
Most common cause of Mitral stenosis
Rheumatic fever - causing autoantibodies that cause pancarditis, esp targeting valves. Mitral most common.
Jone’s Criteria for rheumatic fever
evidence of recent Group A Strep infection (culture, AB titre, scarlet fever)
AND 2 MAJOR diagnostic criteria (carditis, migrating polyarthritis, moving rash, nodules)
OR 1 MAJOR and 2 Minor diagnostic criteria (fever, inflammation blood tests, joint pains w/o inflammation, increase PR int)
Consequences of mitral stenosis (4 categories)
Dyspnea (Pulm. edema, orthopnea/PND),
Hemoptysis (chronic, cough up blood due to bronchial vein rupture),
Fatigue (backup to R side),
Arrythmias (A fib due to stretch, can cause emboli)
Consequences of A fib
Can cause emboli!
Changes in heart sounds due to mitral stenosis
opening snap, S1 louder, rumble. Snap and S1 diminish, snap gets closer to S2, and rumble gets longer as it progresses
Tests and results for mitral stenosis
“EKG - LA and RV larger, A fib
Echo - see severity of valve and functions
CXR - calcified valve, Kerley B lines and edema, enlarged heart
Cardiac catheterization - measure pressures”
Natural progression of mitral stenosis disease
10 year intervals. Rheumatic fever - signs of MS - mild symptoms - A fib - severe symptoms - death
Prevention of mitral stenosis
Treat strep throat quickly; if not, 10 yrs/lifelong monthly IM penicillin
Drug therapy to use for someone with mitral stenosis
Diuretics, coumadin (for a fib), ß blockers (slow HR, more time in diastole).
Interventions for mitral stenosis
Valve replacement, Balloon valvuloplasty, Commissurotomy (open heart, cut open MV a bit)
risks with surgery valve replacement
Greater risk for clots and then risk with blood thinners, infections, endocarditis
Summary of Tx and indications
“Rheumatic fever - treat, prevent recurrence
Mild - drugs
A fib/moderate - consider balloon/commissurotomy
Severe - valve replacement”
