Mitral &Tricuspid Valve Disease Flashcards
What are the basic components of the mitral valve?
- Annulus (fibrous ring around valve)
- Leaflets
- Chordae
- Papillary muscles
What is the normal function of the mitral valve?
- Opens during Diastole (blood goes from LA–> LV)
- Closes during Systole
What is mitral valve stenosis?
Decreased valve opening. Preventing normal flow from LA to LV.
Increased pressure in LA.
What are the most common causes of Mitral Stenosis?
- Rheumatic MS (80-99%)
- Calcific MS (~3%)
What causes Rheumatic Fever (which causes Rheumatic stenosis)?
Group A Strep. Remember from last unit?
As a bonus, can you name the Jones Critera associated with Rheumatic fever?
J-joints
♥- Heart
N-Nodues
E-Erythema margination
S-Sydenham’s Corea
How does a patient with Mitral Stenosis present to the clinic?
- Dyspnea
- Caused by High LA pressure and Pulmonary edema
- Hemoptysis (coughing up blood)
- Caused by inc pulmonary pressures and rupture of bronchial vein.
- Pulmonary Hypertension
- RHF (edema, ascites)
Decreased blood flow and increased LA pressures in Mitral Stenosis puts patients at risk for developing _______&_______.
Inc Pressure –> A-fib
Dec Flow–> Stroke/clot formation
In a patient with Mitral Stenosis, what abnormal findings would you expect to find during ascultation?
- Loud S1
- Opening Snap followed by diastolic rumble
True or False:
In Mitral stenosis, the leaflets lose compliance and decrease the size of the opening.
True.
The opening of the valve is much smaller (called “fish-mouth opening”) in MS when compared to normal.
What is the main medication for treating mitral stenosis?
Beta-blockers- slow down heart to allow more blood to flow through the valve.
Also use diuretics to treat CHF symptoms and Anticoags if A-fib is present.
What procedural operations are involved with Mitral Stenosis intervention?
- Ballon Valvuloplasty (typically done with rhuematic MS becaue valve isnt calcified, so you just rip the fusions between leaflets)
- Mitral valve Replacement
What is the most common cause of Primary Mitral Regurgitation?
Mitral Valve Prolapse
What is the most common cause of Functional Mitral Regurgitation?
Severe LV dysfuntion and dilation
What is the halmark noise of a mitral valve prolapse on ascultation?
Midsystolic Click followed by a systolic murmur
What is the clinical presentation of a patient with Mitral Regurgitation? How do you treat?
Presentation: CHF symptoms
Treatment:
- Diuretics and Afterload reduction
- Surgically repair MV (repair is favored compared to replace)
What is the difference between Primary and functional Valve disease?
Primary: Something is physically wrong with the valve
Functional: Caused by problems with Left Ventricle (dilation, dysfunction)
What is the most common cause of tricuspid valve regurgitation?
RV pressure/volume overload.
What physical exam finding is common in tricuspid regurgitation?
Holosystolic murmur along sternal border that increases with inspiration.
How does a patient with Tricuspid regurgitation present in a clinic?
Dyspnea, Edema, Ascites, liver dysfunction (possible hepatomegaly)
How do you treat tricuspid regurgitation?
Meds: Diuretics
Surgery: Repair at the time of mitral valve repair.
What is the main cause of tricuspid stenosis?
The tricuspid stenosis murmur is similar to _________ murmur.
Prevalent or Rare?
How do you treat it?
Rheumatic fever
Similar to mitral stenosis murmur
RARE
Diuretics or surgery when doing mitral valve operations.
Note all these are on one card because she didnt really care about this too much.
