Valves - Mitral Stenosis Flashcards
What is the mitral valve made up of?
2 leaflets - a bicuspid valve
What are the 2 leaflets of the mitral valve anchored to?
Papillary muscles by chordinae tendinae
What are the 2 names of the leaflets?
Anterior and posterior mitral valve leaflets
Which of the leaflets is smaller and more semi-lunar in shape?
Posterior
What is mitral stenosis?
A valvular heart disease characterised by narrowing of the orifice of the mitral valve of the heart
Aetiology?
Rheumatic heart disease - most common
Congenital mitral stenosis
“Lupus”
Mucopolysaccharidoses
When does the pathophysiology of the effects occur?
When the orifice goes below 2cm
What happens when the orifice goes below 2cm?
Pressures increase in the:
A-V pressure gradient
Left atrium
Pulmonary artery, venous and capillary vessels
Pulmonary vascular resistance increases - causing pulmonary HT
Right heart dilatation with tricuspid regurgitation and pulmonary regurgitation
LV pressure and systolic function remains normal
Symptoms of mitral stenosis?
Dyspnoea
Fatigue
Palpiatations
Chest pain
Hoarseness - compression of L recurrent larungeal nerve
Haemoptysis - rupture of think walled veins
Infective endocarditis
What is observed on an examination?
Mallar flush on cheeks due to reduced cardiac output
Low volume pulse
A-fib
Prominent “a” wave of JVP
Tapping non displaced apex beat with a diastolic thrill
RV heave
Systemic embolisation
What is heard on Auscultation?
A loud s1
Opening snap which is closer to s2 and more severe
Rumble of diastolic murmur which is long
What investigation can be done?
ECG catheterisation
CxR
Echocardiography
Cardial MRI
What does an ECG catheterisation look for?
A-fib
RV Heave
Mitral valve calcification
What will a CxR look for?
LA enlargement
Pulmonary oedema
What will an echo look for?
Thickening and scarring of the leaflets
