Mitral Stenosis Flashcards
What is heard on the apex in mitral stenosis?
Tapping
What effect does mitral stenosis have on the heart sounds?
- Loud S1
What is the clinical definition of mitral stenosis?
- Mitral valve orifice <2cm
What does mitral stenosis result in in the left atrium and pulmonary system?
- Increasing pressure
What does an increase pressure in the left atrium and pulmonary circulation result in?
- Right heart dilation
How do you auscultate the diastolic murmur caused by mitral stenosis?
- Patient lying on their left hand side
- Auscultate with bell on apex
Symptoms?
- Dyspnoea
- Haemoptysis
- Chest pain
- Hoarseness
What causes dyspnoea in mitral stenosis?
- Exertion due to pulmonary oedema
What causes haemoptysis in mitral stenosis?
- Rupture of thin vein walls
What causes hoarseness in mitral stenosis?
- Compression of left recurrent pharyngeal nerve similar to a pancoast tumour
Signs?
- Right heart dilation
- Pulmonary oedema (base)
- Systemic embolisation
- Rosie facial flush
- Normal pulse
- Prominent JVP A wave
- Tapping apex beat
- Mid diastolic thrill
- Right ventricular heave
- Loud S1
Causes of mitral stenosis?
- Rheumatic heart disease
- Congenital mitral stenosis
- SLE
Initial investigations?
- ECG
- CxR
- Echocardiogram
- Cardiac magnetic resonance imaging
What will you find on an ECG?
- P wave longer than 0.12s
What will be seen on a CxR?
- LA enlargment
What will be evident in the echocardiogram?
- Thickening and scarring of leaflets
Treatment?
- Diuretics
- Anti-coagulation
Surgical options?
- Percutaneous mitral balloon valvotomy
- Mitral valve replacement
