Valves - Mitral Regurgitation Flashcards
What is MR?
MV does not close properly when heart pumps out blood
Aetiology?
Rheumatic heart disease
Mitral valve prolapse
Degenerative valve (calcified)
Infective endocarditis
MI - causes papulliary muscles/chordinae tendinae to rupture which stops MV being held in place
Functional MR due to LV and annular dilatation
What happens in acute MR?
When blood spills back into LA - the LA won’t allow for dilatation and the LA pressure rises
This increases pulmonary venous pressure causing pulmonary oedema
What happens in chronic MR?
Blood spills into LA, LA starts to dilatate and increase in size but little increase in presssure
What causes LVH?
EDV increases to return ESV to normal
How does acute MR show as symptoms?
Dyspnoea
Pulmonary oedema
Cardiogenic shock
How does chronic MR present?
Normally asymptomatic until it gets really bad and RH failure develops
Dyspnoea
Fatigue
Palpitations
Reduced pulse JVP prominent RV heave Brisk apex beat IE
What causes fatigue ?
Low CO due to right sided heart failure
What causes palpitations?
A-fib
What can be heard on auscultation
Pan systolic murmur radiating to left axilla
Diminished s1 sounds
What investigations can be done?
ECG
CxR
Cardiac catheterisation
Echocardiography (USS)
Acute cardiac volumes
Volumeric determination of regular volume
What is looked for in an ecg?
LA enlargement
A-fib
RVH
What is looked for in a CxR?
Cardiomegaly
LA enlargement
Calcification of mitral annulus
What is looked for in cardiac catheterisation?
LV angiography - the vessels
What’s looked for in an echo?
Causes of the MR - leaflet problems, annular disease, state of pap muscles
Severity of MR and pap muscle damage
