Mitrial Stenosis

Question 1

Define Mitral Stenosis

Answer 1

Narrowing of the mitral valve orrifice-thickening of the valve leaflets

Question 2

Aetiology and risk factors

Answer 2

MAIN CAUSE: Rheumathic fever
can be congenital, SLE, serotonin drugs, carcinoid, amyloidosis
ageing

flow limit of the valve causes:
Increased left atrial pressure is referred to the lungs, where it leads to congestion and the symptoms associated with it

The restricted orifice limits filling of the left ventricle, thereby limiting cardiac output.

Question 3

Epidemology of Mitral Stenosis

Answer 3

mainly caused by rheumatic fever-not too common in uk

quite common in other countries

Question 4

Symptoms of Mitral Stenosis

Answer 4

often asymptomatic-present often as orrifice is less than 2cm
Orthopnea
Heart related: Dyspnoae, fatigue, palpitation, chest pain, systemic emboli

Lung related: heamoptosis, chronic bronchitis

Question 5

Signs of Mitral Stenosis

Answer 5

Malar flush on cheeks
AF can be common
Tapping, non displaced apex beat
neck vein distention (sign of palm HTN)
Hoarsness, oedema, ascites

LOUD S1, normal S2, opening snap and rumbling mid-diastolic murmur (best heard during expiration)

Question 6

tests for Mitral Stenosis

Answer 6

ECG–AF common
P-mitale, RVH

CXR- left atria enlargement, pulm oedema, mitral valve calcification

Echocardiography-diagnostic
can just look at hole size

manage-control rate of AF, anticoagulant, reduce fluid, valvuloplasty, valve replacement