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Z Year3 Cardio Conditions > Mitral Valve Disease > Flashcards

Mitral Valve Disease Flashcards

1
Q

What are two types of mitral valve disease?

A

Mitral regurgitation and Mitral stenosis

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2
Q

What happens in mitral regurgitation (MR)?

A

backflow through mitral valve during systole

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3
Q

What are the causes of mitral regurgitation?

A
  1. Functional (LV dilation)
  2. Annular calcification (elderly)
  3. Rheumatic fever
  4. Infective endocarditis
  5. Mitral valve prolapse
  6. Connective tissue disorders
  7. Cardiomyopathy
  8. Congenital
  9. Appetite suppressants
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4
Q

What is mitral valve prolapse?

A

most common valvular abnormality (5% prevalence)

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5
Q

When does mitral valve prolapse occur?

A

alone or with ASD, patent ductus arteriosis, cardiomyopathy, Turner, Marfarns, etc and mitral annular disjunction (MAD)

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6
Q

What are symptoms of mitral valve prolapse?

A

Usually asymptomatic or chest palpitations and autonomic dysfunction

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7
Q

What are the signs for mitral valve prolapse?

A

mid-systolic click and or a late systolic murmur

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8
Q

What are complications of mitral valve prolapse?

A
  1. MR
  2. Cerebral emboli
  3. arrhythmia
  4. sudden death
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9
Q

What Ix is diganostic for mitral valve prolapse?

A

echo

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10
Q

What can ECG show for mitral valve prolapse?

A

t wave inversion or signs of infection

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11
Q

What is management for mitral valve prolapse?

A
  1. Beta blocker can help chest pain or palpitation 2. Surgery if severe MR
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12
Q

What are causes of mitral stenosis?

A
  1. Rheumatic fever
  2. Congenital
  3. Prosthetic valve
  4. Malignant carcinoid
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13
Q

What are RF for mitral stenosis?

A
  1. Strep infection
  2. Female sex
  3. 40-50
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14
Q

What are the symptoms of MR?

A
  1. Dyspnoea
  2. Fatigue
  3. Palpitations
  4. Symptoms of causative factor e.g. fever
  5. Lower extremity oedema
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15
Q

What are the signs of MR?

A
  1. AF
  2. Displaced, hyperdynamic apex
  3. Pansystolic murmur at apex radiating to axilla
  4. Soft S1
  5. Soft S2
    - The more severe the larger the left ventricle
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16
Q

When do you get MS symptoms?

A

begin when orifice >2cm

17
Q

What are symptoms of MS?

A

Pulmonary hypertension causing

  1. Dyspnoea
  2. Haemoptysis
  3. Chronic bronchitis
  4. Hoarseness
  5. Dysphagia
  6. Fatigue
  7. Palpitations
  8. Chest pain
  9. iE
18
Q

What are the signs in MS?

A
  1. Malar flush (decreased cardiac output)
  2. Low volume pulse
  3. AF (due to large LA)
  4. Tapping non-displaced apex beat
  5. RV heave
  6. Loud S1
  7. Opening snap
  8. Rumbling mid-diastolic murmur (heard on expiration with patient on left side)
  9. Loud P2
  10. Neck vein distention
19
Q

What happens the most severe stenosis in MS?

A

More severe the stenosis, the longer diastolic murmur and the closer opening snap is to S2

20
Q

What are possible DDx for mitral valve disease?

A
  1. ACS
  2. Infective endocarditis
  3. Mitral stenosis
  4. Aortic stenosis
21
Q

What is diagnostic for both MS and MR?

A

transthoracic echo

22
Q

What would ECG show on MR?

A
  1. AF
  2. P mitrale if in sinus rhythm
  3. left ventricular hypertrophy
23
Q

What would ECG show in MS?

A
  1. AF
  2. P mitrale
  3. RVH
24
Q

What would CXR show in MR?

A
  1. Big LA and LV
  2. mitral valve calcification
  3. pulmonary oedema
25
Q

What would CXR show in mitral stenosis?

A
  1. LA enlargement
  2. pulmonary oedema
  3. mitral valve calcification
26
Q

What can cardiac cathertirisation show?

A

indication are previous valvotomy, signs of other valve disease, angina, severe pulmonary hypertension calcified mitral valve

27
Q

What is the management plan for MR?

A
  1. Control rate if fast AF
  2. Anticoagulated if AF, history of embolism, prosthetic valve additional mitral stenosis
  3. Diuretics to improve symptoms
  4. Surgery for deteriorating symptoms, aim to repair or replace valve before LV irreversibly impaired e.g. annuloplasty
28
Q

What is the management plan for MS?

A
  1. Rate control is crucial
  2. Anticoagulants
  3. Diuretic to decrease preload and pulmonary venous congestion
  4. If these fail to control symptoms can do ballon valvuloplasty, open mitral valvotomy or valve replacement
29
Q

What are complications in MR?

A
  1. AF
  2. Pulmonary hypertension
  3. Post op stroke
  4. LV dysfunction and CHF
30
Q

What are complications in MS?

A
  1. Stroke
  2. AF
  3. Warfarin induced haemorrhage
  4. IE

Z Year3 Cardio Conditions (22 decks)

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