Valvular disease Flashcards
Causes of mitral stenosis
Rheumatic heart disease
Congenital
mitral stenosis has what pathophysiological effect
Pulmonary oedema, pulmonary hypertension, Right ventricle dilation and tricuspid regurgitation. LA dilation
Symptoms of mitral stenosis
dyspnoea
rupture of thin walled veins
Chest pain
hoarseness due to compression of laryngeal nerve
Mitral stenosis clinical features
Mitral facies (very red nose and cheeks) Prominent JVP seen when ventricles contract tapping apex beat RV heave diastolic heave
Auscultation of mitral stenosis
Hear blood movement between S2 and S1
CXR signs of mitral valve stenosis
Left atrium enlargement
Mitral valve stenosis treatment
Diuretics control any AFib anticoagulants if have AFib valvotomy (surgical widening of the valve) Mitral valve replacement
Causes of mitral regurgitation
Rheumatic Heart Disease
Mitral valve prolapse (MVP)
degenerative
Causes of acute mitral regurgitation
valve perforation (tear in the valve) damage to papillary muscle or chordae tendinea
Symptoms of Acute Mitral regurgitation
Sudden dyspnoea
pulmonary oedema
Cardiogenic shock (fast HR low Bp)
Symptoms of chronic mitral regurgitation
fatigue
right heart failure
dyspnoea
Clinical feature of mitral regurgitation
raised JVP if heart failure has occurred
RV heave
strong apex beat
Auscultation of mitral regurgitation
Murmur between S1 and S2
mitral regurgitation investigation’s
ECG- shows LA enlargement
CXR- shows cardiomegaly, LA enlargement
Calcification of mitral annulus (part surrounding the valve)
echocardiogram would show the cause
Treatment for acute mitral regurgitation
Fast blood pressure lowering drugs
intra-aortic balloon pump
surgery to fix
Treatment for chronic mitral regurgitation
no pharmacological l treatment
possible replacement of corrective surgery
Causes of Aortic stenosis
degenerative (linked to atherosclerosis)
Rheumatic
congenital bicuspid valve
aortic stenosis has what pathophysiological effect
increased systolic pressure causes severe hypertrophy increased size and strength of contraction due to high pressure causes high myocardial 02 use myocardial ischemia LV heart failure
Aortic stenosis symptoms
Long asymptomatic phase
angina
syncope and dyspnoea on exertion
heart failure symptoms
Aortic stenosis clinical features
weak pulse raised JVP low Bp strong apex beat RV heave
Auscultation of aortic stenosis
Loud murmur between S1 and S2
What investigations would you do for suspected aortic stenosis
ECG- ST changes may indicate LV strain
CXR- Calcification of aortic valve
Echocardiograph- shows pretty much the whole shibang
Aortic stenosis treatment
If heart failure then treat that
Aortic valve replacement if needed
Causes of Aortic regurgitation
Dilated aorta
bicuspid valve
rheumatic
endocarditis
