Mitral Valve Disease Flashcards

1
Q

How does mitral stenosis progress?

A

Pressure builds up in the Left Atrium which backs up through the pulmonary circ causing pulmonary hypertension.
As a result the Right heart dilatates with Tricuspid and pulmonary regurgitation.

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2
Q

What can cause mitral stenosis?

A

Mainly Rheumatic Heart Disease fibrosing the valve.
Also Congenital Mitral Stenosis
Occasionally systemic conditions like lupus erythematosus or rheumatoid arthritis

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3
Q

What are the symptoms of mitral stenosis?

A

Dyspnoea & Pulmonary Oedema
Haemoptisis should small veins rupture due to pulmonary hypertension
Systemic embolisation due to enlargement of LA & LAA
Chest Pain
Hoarseness (enlarged heart compresses L Recurrent Laryngeal Nerve)

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4
Q

What are the clinical signs of mitral stenosis?

A

A Diastolic Thrill & Tapping Apex Beat
A RV Heave due to dilatation
A 3rd heart sound & blowing sound durin diastole when auscultating the MV
Mitral Facies

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5
Q

How do we investigate suspected Mitral Stenosis?

A

An ECG,
CXR - LA enlargement
Echocardiogram - Thickening/Scarring of mitral leaflets
CMR

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6
Q

How can we treat mitral stenosis?

A

If in Afib then Sinus Rhythm Restortation & Anti-Coagulants
Diuretics & Low Na Intake to lower BP
Valvotomy - Widenin the valve with a baloon or surgery
Mitral Valve Replacement

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7
Q

When does MS often become apparent?

A

When the patient becomes tachycardic

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8
Q

What are the possible causes of mitral regurgitation?

A

Again Mainly Rheumatic Heart Disease
Also could be:
Mitral Valve Prolapse - Infect. Endocarditis - Degenerative Disease - Ventricle enlargement stretching the valve

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9
Q

What are the symptoms of Mitral Regurgitation?

A

Acute MR:
Dyspnoea - Pulmonary Oedema - Cardiogenic Shock

Chronic MR:
Fatigue - Exhaustion - RH enlargement & failure - Dyspnoea/Palpitations due to Afib

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10
Q

What are the clinical signs of mitral regurgitation?

A

A brisk, hyperdynamic apex beat
A RV Heave due to Hypertrophy
Upon auscultating the mitral valve, blowing at apex radiating to axilla
If RHF then high JVP + Low pulse.

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11
Q

What would do to investigate potential Mitral Regurgitation?

A

An ECG, CXR & Echo

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12
Q

What would appear on an MR ECG?

A

A tall P wave indicating LA enlargement
And a prominent R wave showing RVH

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13
Q

How would Mitral Regurgitation show on a CXR or Echo?

A

CXR: Cardiomegaly - LA enlargement - Calcified Mitral Annulus
Echo: Annular Disease - MR severity - Dysfunction of leaflets, chordae or pap muscles.

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14
Q

How do we treat Mitral Regurgitation?

A

Acute MR:
Use Na nitroprusside OR Dobatumine to lower preload/afterload

Chronic MR:
Diuretics can reduce symptoms but will still need surgery

Surgery:
Eventual will need MV repair/Replacement

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