VALVULAR DISORDERS

Question 1

ACUTE LEFT SIDED REGURGITATION (MITRAL / AORTIC REGURGITATION)

Answer 1

CLINICAL FEATURES
Pulmonary Edema
Peripheral Edema
Cardiogenic Shock

low-pitched systolic decrescendo murmur. Only 50% of patients will have a new murmur.

HISTORY
Ask about:
Symptoms of Aortic Dissection or MI
Acute / Subacute MI (MR)
Prior valvular disorders or rheumatic heart disease
Prior cardiac or valvular surgery
Risk factors for Endocarditis

POCUS
normal or hyperdynamic left ventricle
Color Doppler: a regurgitant jet filling >30% of the left atrium in mitral regurgitation or >30% of the left ventricular outflow tract in aortic regurgitation is diagnostic for moderate to severe mitral or aortic regurgitation

MANAGEMENT
Emergency surgical repair or replacement