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Cardiology > Mitral Stenosis > Flashcards

Mitral Stenosis Flashcards

1
Q

How is mitral stenosis defined clinically?

A
  • Diameter of mitral valve orifice is less than 5cm2
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2
Q

What is the most common cause of mitral stenosis?

A
  • Rheumatic heart disease
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3
Q

Identify three clinical features of mitral stenosis

A
  • Dyspnoea
  • Palpitations
  • Mitral facies
  • Palpitations
  • Peripheral oedema
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4
Q

Identify two findings on auscultation

A
  • Loud first heart sound
  • Opening snap
  • Rumbling mid-diastolic heard over the apex with patient on left side
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5
Q

Identify two findings on ECG

A
  • Bifid P waves due to delayed left atrial activation
  • Absent P waves due to AF
  • Tall R waves in V1
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6
Q

Identify two findings on CXR

A
  • Large left atrium

- Distended pulmonary veins

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7
Q

What is seen on transthoracic echocardiography?

A
  • Hockey stick shape mitral valve deformity
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8
Q

What is seen on transoesophageal echocardiography?

A
  • Left atrial thrombus
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9
Q

Identify a differential diagnosis of mitral stensosis?

A
  • Atrial fibrillation

- Left atrial myxoma

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10
Q

What is the role of anticoagulants in therpay?

A
  • Reduce risk of systemic embolism of left atrial thrombus
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11
Q

Identify three possible medications for ventricular rate control in atrial fibrillation

A
  • Atenolol
  • Diltiazem
  • Digoxin
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12
Q

Identify three criterion for mitral ballon valvuloplasty

A
  • Isolated mitral stenosis with no mitral regurgitation
  • Non calcified valve on echocardiography
  • No left atrial thrombus on TOE
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13
Q

Identify three criteria for mitral valve replacement

A
  • Simultaneous mitral regurgitation
  • Calcified mitral valve
  • Left atrial thrombus on TOE
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14
Q

Identify two investigations in rheumatic fever

A
  • Throat swabs for group A streptococci

- Antistreptolysin O titre

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15
Q

Identify two major manifestations of the Revised Jones criteria

A
  • Carditis (murmurs, cardiomegaly, pericarditis, myocarditis)
  • Polyarthritis
  • Chorea
  • Erythema marginatum
  • Subcutaneous modules
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16
Q

Identify two minor manifestations of the Revised Jones criteria

A
  • Fever
  • Arthralgia
  • Raised CRP
  • Leucocytosis
  • First degree AV block
  • Previous rheumatic fever
17
Q

How can the revised Jones criteria be used to diagnose rheumatic fever

A
  • At least 2 major manifestations

- At least 1 major and 2 minor manifestations

18
Q

What is the treatment of rheumatic fever

A
  • Oral phenoxymethylpenicillin 500 mg four times daily
19
Q

What percentage of patients with rheumatic fever will develop chronic rheumatic valvular heart disease?

A
  • 50+ %

Cardiology (16 decks)

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