mitral stenosis Flashcards
mitral stenosis
blood is unable to flow from the left atrium to the left ventricle
aquired mitral stenosis
rheumatic valve disease infective bacterial endocarditis valvular/annular calcification left atrial myxomo thrombus prosthetic valve dysfunction
congenital mitral stenosis
fusion of chordae
papillary muscle malposition
parachute valve
pulmonary vein stenosis
mitral stenosis on left ventricle
decreased LV filling
decreased cardiac output
LV failure
mitral stenosis on left atrium
increased LA end diastolic volume left atrial enlargment a-fib no atrial kick thromboembolic event
mitral stenosis on the pulmonary
increased left atrium end diastolic pressure increased pulmonary venous pressure RV hypertrophy dyspnea hemoptysis
mild to moderate mitral stenosis symptoms
dyspnea with extreme exertion orthopnea paroxymal nocturnal dyspnea hemoptysis a-fib
severe mitral stenosis
rest dyspnea disability
Physical exam findings for mitral stenosis
- palpation of S1 over the percordium is pathognomic for mitral valve stenosis
- diastolic thrill palpable in left lateral decubitus position
- accentuated S1 easly
- low pitched rumbling diastolic murmur
- JVD
mitral stenosis on x-ray
LA enlargement
elevated left main stem of bronchus
ECG for mitral stenosis
- left atrial enlargement- biphasic p-waves or notched t waves
- right ventricular hypertrophy (right axis deviation)
- a-fib
mitral echocardiogram
large left atrium
high pressure gradient through the valve
mitral valve disease progression
latent period-s slow progression 10 yrs
-symptoms onset with rapid progression (typically seen in the 4th decade of life or with pregnancy)
mitral stenosis classification
minimal: greater than 2.5
mild: 1.4-2.5
moderate: 1-1.4
severe less than 1
reactive pulmonary HTN less than 1
symptomatic medical treatment of mitral stenosis
loop diuretics
if a-fib anticoagulation and rate control
