valvular heart disease

Question 1

what is the definition of mitral stenosis ?

Answer 1

inability of mitral valve to open properly when it needs to be open ( in diastole )

Question 2

what are the causes of mitral stenosis ?

Answer 2

Rheumatic heart disease –> most common cause ( 95% ) of the cases

Other causes :

Congenital
Calcific —> degenerative

Austin flint murmur –> Aortic regurg

Carry coombs murmur in rheumatic valvulitis

increased flow through Mitral valve —> like mitral regurg

Question 3

what are the clinical features of mitral stenosis ?

Answer 3

Pulmonary hypertension –> cuz blood cant leave left atrium

pulmonary congestion

systemic congestive in severe stenosis

Atrial dilation –> fibrillation

Malar flush due to low cardiac output and pulmonary hypertension

Thrombus in valve —> emboli —> neurological damage , absent pulse , sudden blindness

Question 4

why do we have pulm colored cheeks in mitral stenosis ?

Answer 4

Low cardiac output + pulmonary hypertension

due to combined hypoxia and cutaneous vasodilation ( Cuz CO2 retention )

Question 5

what are the mitral stenosis murmurs?

Answer 5

Mid diastolic murmur –> rumbling , localized over apex

Low pitched —> use Stethoscope BELL

position the patient on Lateral side and listen after breath holding expiration

Opening snap following S2 ( diastole )

S1 –> systole —> S2 —> diastole —> S1

Accentuated S1

Question 6

describe the ECG for mitral stenosis ?

Answer 6

P MITRALE

Wide based notched P waves due to left atrial enlargement

Question 7

what are the x ray features of mitral stenosis ?

Answer 7

Butter fly wing appearance

DUE TO PULMONARY CONGESTION AND EDEMA

obliterated cardiac waist due to LA dilation

cardiomegaly to RV dilation