valvular heart - mitral regurgitation

Question 1

what type of disorder is MR?

Answer 1

the mitral valve on the left side of the heart does not close properly

regurgitation means leaking from a valve that does not close all the way

Question 2

what 7 disorders cause MR?

Answer 2

Rheumatic Heart Disease

Mitral Valve Prolapse (MVP)

Infective Endocarditis (IE)

Ruptured chordae tendinae

Ruptured Papillary Muscles

Degenerative

Functional Mitral Regurgitation due to the dilatation of the Left Ventricle and Annular.

Question 3

what are 4 symptoms of MR (including acute and chronic MR)?

Answer 3

Breathlessness
Fatigue
Palpitations (if AF)
Infective Endocarditis

Acute MR:
Breathlessness,
Pulmonary Oedema
Cardiogenic Shock (heart suddenly can’t pump enough blood that is required)

Chronic MR:
Right heart Failure
Atrial Fibrillation (causes Dyspnoea and Palpitations), Fatigue, Exhaustion (low Cardiac Output)

Question 4

what are the 5 signs of MR?

Answer 4

Right Ventricle heave

Apex Beat = Hyperdynamic, Displaced, and Brisk

Auscultation = Pansystolic Murmur radiating to Axilla (Reduced S1, Split S2: Early A2, and a Loud P2)

Pulse = normal (but if heart failure then reduced)

JVP = prominent if Right Heart failure is present

Question 5

what 4 investigations are carried out to diagnose MR?

Answer 5

ECG
Echocardiography
CXR
Cardiac Catheterisation (confirms diagnosis)

Question 6

what 4 treatments are used?

Answer 6

Mitral Valve replacement, or Mitral Valve repair

Anticoagulation (if Atrial Fibrillation)

Diuretics

Tackle Acute MR = Sodium Nitroprusside, Dobutamine, and IABP