Valvular Heart Disease - INCOMPLETE Flashcards
1
Q
Which of the mitral valve cusps is the biggest?
A
- Anterior
2
Q
How are the cusps anchored to the papillary muscles?
A
- By the chordae tendinae - Both cusps are anchored to both papillary muscles
3
Q
What conditions can lead to mitral stenosis?
A
- Rheumatic heart disease - Congenital mitral stenosis (rare) - SLE - Rheumatoid arthritis
4
Q
What size is diagnosed as mitral stenosis?
A
- An MV orifice of <2cm^2
5
Q
What happens to the AV pressure gradient during MS?
A
- Increases
6
Q
What happens to the pulmonary venous and capillary pressures during MS?
A
- Increases
7
Q
What happens to PVR and PaP in MS?
A
- Increase
8
Q
What develops in response to MS?
A
- PHT - RH dilatation with TR and PReg
9
Q
What two things do you use to asses M stenosis severity?
A
- Effect on trans valvular pressure gradient - Effect on trans valvular flow rate
10
Q
What are the clinical presentations of M stenosis?
A
- Dyspnoea (mild exertional all the way to pulmonary oedema) - Haemoptysis - Systemic embolisation - Infective endocarditis - Chest pain - Hoarseness
11
Q
What causes haemoptysis in MS?
A
- Rupture to thin walled veins
12
Q
What causes systemic embolisation in MS?
A
- LA enlargement - LAA enlargement
13
Q
What causes hoarseness in MS?
A
- Compression of the L recurrent laryngeal nerve
14
Q
What signs are apparent on examination?
A
- Mitral facies - Normal pulses - Prominent a wave of JVP - Tapping apex beat - Diastolic thrill - RV heave - Diastolic murmur on auscultation
15
Q
Describe the ECG of someone with M stenosis
A
- Atrial fibrillation - No visible P wave (irregularly irregular)
- Suggestion of LVH from right axis deviation and deep S waves in lateral leads