Mitral Stenosis (Easy)

Question 1

Mitral stenosis?

Answer 1

• It is said that the causes of mitral stenosis are rheumatic fever, rheumatic fever and rheumatic fever.
• Rarer causes that may be seen in the exam include mucopolysaccharidoses, carcinoid and endocardial fibroelastosis

Question 2

Features?

Answer 2

• mid-late diastolic murmur (best heard in expiration)
• loud S1, opening snap
• low volume pulse
• malar flush
• atrial fibrillation

Question 3

Mitral Stenosis Mnemonic?

(Diastolic)

Answer 3

Mitral Stenosis Classical Features:

‘Stenosis’

S - S1 is loud

T - Tapping Apex Beat

E - Enlargement of Left Atrium

N - Normally Split S2

O - Opening Snap heard (Ortners Syndrome)

S - Systemic Vascular Resistance Increases

I - Indentaion of Oesophagus

S - Stag Antlers sign seen on X ray

Low Pulse Volume

Question 4

Aortic Regurgitation?

(Diastolic)

Answer 4

Question 5

Aortic Regurgitaion - Mnemonic

Answer 5

Question 6

Mitral regurgitation?

Answer 6

Features:

• pan-systolic murmur
• soft S1, split S2

Question 7

Aortic stenosis?

Answer 7

Features of severe aortic stenosis:

• narrow pulse pressure
• slow rising pulse
• delayed ESM
• soft/absent S2
• S4
• thrill
• duration of murmur
• left ventricular hypertrophy or failure

Question 8

Causes of aortic stenosis?

Answer 8

• degenerative calcification (most common cause in older patients > 65 years)
• bicuspid aortic valve (most common cause in younger patients < 65 years)
• William’s syndrome (supravalvular aortic stenosis)
• post-rheumatic disease
• subvalvular: HOCM

Question 9

Management?

Answer 9

• if asymptomatic then observe the patient is general rule
• if symptomatic then valve replacement
• if asymptomatic but valvular gradient > 40 mmHg and with features such as left ventricular systolic dysfunction then consider surgery
• balloon valvuloplasty is limited to patients with critical aortic stenosis who are not fit for valve replacement

Question 10

Answer 10

Question 11

Easy Mitral Stenosis Mnemonic?

Answer 11

Mitral Stenosis

(MALLM)

M alar Flush

A trial Fibrillation

L ow Volume Pulse

L oud S1

M id to late Diastolic Murmur

Question 12

Easy Aortic regurgitation Mnemonic?

Answer 12

Aortic Regurgitation

(WECOM)

W ide pulse pressure

E arly diastolic murmur

Collapsing pulse

M id-diastolic Austin-Flint murmur in severe AR

Question 13

Easy Mitral regurgitation Mnemonic?

Answer 13

Mitral Regurgitation

(PSS)

P an Systolic Mumur

S oft S1

S plit S2

Question 14

Easy Aortic Stenosis Mnemonic?

Answer 14

Aortic Stenosis

(NSSS)

N arrow pulse pressure

S low rising pulse

S oft/absent S2

S 4