Mixed Mitral Valve Disease

Question 1

Features

Answer 1

Signs of both MS MR

Find out which is dominant

Question 2

Dominant MS

Answer 2

Apex is tapping and not displaced
H1 loud
H3 absent

Question 3

Dominant MR

Answer 3

Apex is heaving and displaced
H1 soft
H3 present

If in doubt do cardiac catheterisation

Question 4

Causes of mixed

Answer 4

Chronic RHD

Question 5

Valves most effected by RHD

Answer 5

Mitral valve 80%
Aortic valve 50%
Combined A and M 20%
Tricuspid 10%
Pul <1%

Question 6

Multiple small calcified nodules on chest radiograph

Answer 6

Long standing elevation of pulmonary venous pressure