Valvular Heart Disease Flashcards
Pulmonary oedema xray
Batwing sign
Main causes of mitral valve stenosis
RHEUMATIC FEVER(main)
Degenerational- annular calcification in elderly,hypertensive patient,patient with atherosclerosis and aortic stenosis
Congenital-subvalvular abnormalities
Very rarely-SLE,infiltrative disease, carcinoid heart disease, drug induced,myxoma
Mitral valve stenosis pathophysiology
During diastole pressure in atria more than ventricle since blood can not pass through. This lead to pressure and blood pushing into pulmonary circulation, leading to pulmonary oedema
Mitral stenosis can effect what other valve
Tricuspid regurgitation can occur since pulmonary pressure increases(due to increased LA pressure), leading to possibly pulmonary hypertension and right ventricular overload. Eventually leading to tricuspid regurgitation
Normal pressure on left side of heart during diastole
During diastole the LA and LV pressure should be equal. But during mitral valve stenosis at the end on diastole the LA pressure is higher than LV pressure (presence of end diastolic gradient)
Mitral stenosis history
Haemoptysis
Dyspnoea
Chest pian
Systemic embolism (can be initial presentation)
Mitral stenosis physical signs
-mitral facies
-bipedal pitting oedema
-small pulse vol
-jvp normal or if pulmonary hypertension already or tricuspid regurgitating it may be raised
-apex undisplaced
-tapping apex
-left parasternal lift if pulmonary hypertension
-palpable p2 if pulmonary hypertension
Auscultation of ms
At apex, diastolic murmur, listen with bell
Xray of ms
Enlarged LA
Enlarged PA
Pulmonary congestion
ECG findings of MS
Treatment for mild ms
Diuretic(treat heart failure)
Beta blockers (slow heart rate, increase filling time)
Anticoagulants (in atrial fibrillation)
Endocarditis and rheumatic fever prophylaxis
Ms treatment surgery
Balloon valvotomy
Endocarditis prophylaxis
Amoxicillin 2g
Clindamycin 600mg
(One hour before procedure)
Causes of aortic stenosis
Degenerative
Congenital
Rheumatic
Leaflet pathology
