Valvular Disease Flashcards
Pathophysiology of Mitral Stenosis
LA pressure increased
Greater pressure difference across valve
Reduced LV filling
Consequences of Mitral Stenosis
Elevation of LA volume and pressure
Reduced EDV and LV pressures (leads to decreased SV, CO, and aortic pressure)
Volume-related stress on LA due to decreased flow into LV
Chronic adaptation of Mitral Stenosis
LA dilation (enlargement) Increased size keeps pressure lower for same blood volume
Outcomes of Mitral Stenosis
Dyspnea
Reduced exercise capacity
Pulmonary congestion
When and what would you hear in mitral stenosis?
Murmur during diastole
Small, but getting louder towards the end
At apex
Pathophysiology of Mitral Regurgitation
SV ejected forward into aorta and back into low pressure LA (decreased flow forward)
Increased LA pressure during systole
Consequences of Mitral Regurgitation
Elevation of LA volume and pressure
Reduced forward SV, CO and aortic pressure
Volume-related stress on LV due to filling with normal plus regurgitated LA volume
Chronic adaptation of Mitral Regurgitation
LA dilation (enlargement)
Increased size keeps pressure lower for same blood volume
LV dilation
Outcomes of Mitral Regurgitation
Fatigue, weakness
Nocturnal Dyspnea
Pulmonary congestion
When and where would you hear Mitral regurgitation?
Constant murmur during systole
At apex
Pathophysiology of Aortic Stenosis
LV pressure increased and greater pressure difference across valve in order to eject blood into the aorta
Reduced SV
Consequences of Aortic Stenosis
Elevation of LV pressure
Increased ESV and LV pressures (decreased SV, CO and aortic pressure)
Pressure-related stress on LV due to valve resistances
Chronic adaptation of Aortic Stenosis
LV hypertrophy
LA dilation in response to high LV diastolic pressure
Outcomes of Aortic Stenosis
Angina
Exertional syncope
Congestive heart failure
When and where would you hear Aortic stenosis?
During systole
Crescendo - decrescendo
At base
