mitral stenosis Flashcards
what does mitral valve consist of
- fibrous annulus
- anterior and posterior leaflets
- chordae tendineae
- papillary muscle
most common cause
rheumatic diseases
what is rheumatic fever due to
infection with group B haemolytic streptococcus
who is more likely to get it men or women
women
what does inflammation lead to
commissural fusion and a reduction in mitral valve orifice area
what happens to the condition over many years
- valve thickening
- cusp fusion
- calcium deposition
- narrowed valve orifice
- immobility of the valve cusp
other causes
- congenital mitral stenosis
- lutembacher syndrome
- clarification
- carcinoid tumours metastasising to lung
what does the heart do to counteract reduced valve area
left atrial pressure increases
- left atrial hypertrophy
- dilatation occur
what does pulmonary hypertension lead to
right ventricular hypertrophy, dilatation and failure
symptoms
- SOB
- cough (blood tinged)
- right heart failure
- weakness
- fatigue
- AF
- palpitation
signs
- AF
- heaving apex
- loud S1
- tapping apex
- mid-diastolic murmur
- malar flush
what murmur is it
mid-diastolic
what is JVP like
a wave
what is apex like
tapping
what is heard on auscultation
loud S1
when is murmur best heard
with patient lying on their left side
what does addition of pulmonary hypertension implies
it is severe
what is done for diagnosis
- CXR
- ECG
- echo
what is seen on CXR
- left atrial enlargement
- calcified mitral valve
what is seen on ECG
- bifid p wave
- AF
- right ventricular hypertrophy (tall wave in V1)
what is seen on echo
- determines left atrial size
- degree of thickening
- clarification
what may need to be done to determine pulmonary artery pressure
cardiac catheterisation
treatment for mild mitral stenosis
none
other than prompt therapy for attacks of bronchitis
treatment when AF begins
beta blockers or DC cardioversion and anticoagulation
