TS

Question 1

Causes of TS;

Answer 1

Almost always d/t RHD ,usually associated w/MS not an isolated lesion

Females >males

Rheumatic TS usually associated with TR

Other causes: SLE,Carcinoid syndrome ,Endocarditis,congenital tricuspid atresia

Question 2

TS Symptoms :

Answer 2

Fluttering discomfort in the neck d:t giant a wave in jaguar pulse

Fatigue and cold skin d/t low CO

RUQ abdominal discomfort d/t enlarge liver

Abdominal distension (hepatomegally and ascites)

Peripheral edema

*ask about hystory of rheumatic fever ,symptom of carcinoid syndrome and congenital abnormalities

Question 3

Px of Ts findings:

Answer 3

Jaundice ,malnutrition,anasarca (d/t liver cirrhosis )

Raised JVP with giant a wave

Pulse:irregularly irregular d/t AF

S2(A2p2) may be single d/t inaudible closure of pulmonary valve from decreased blood flow

Opening snap followed by MID-DIASTOLIC murmur best Heard- I left lower stet all border
INCREASED BY INSPIRATION

hepatomegaly and ascites ,Pedal edema d/t marked hepatic congestion leading to cirrhosis and ascites

Question 4

Investigation TS:

Answer 4

ECG :
P pulmonale (enlarged RA )

CXR :
Prominent RA and SVC (superior vena cava )

Echo ;