Valvular disease Flashcards
Pathophysiology of mitral stenosis
AV pressure gradient increases
LA pressure increases
pulmonary venous and capillary pressure increases in vascular resistance
clinical signs of mitral stenosis
dyspnoea, haemoptisis, systemic embolism, IE, chest pain and hoarseness
clinical examination of mitral stenosis
mitral facies- purple discolouration
normal pulse
raised JVP
tapping apex and diastolic thrill
RV heave
treatment for mitral stenosis
diuretics and restrict salt intake. anticoagulants
what can mitral regurgitation lead to
rheumatic heart disease
mitral valve prolapse
IE
clinical signs of mitral regurgitation
Acute- breathlessness, pulmonary oedema, cardiogenic shock
Chronici- fatigue, exhaustion, Right heart failure, dyspnoea
examination of mitral regurgitation
reduced pulse
prominent JVP
RV heave
rheumatic stenosis
fusion of commissures and retraction and stiffening of the free cusp margins
degenerative aortic stenosis
linked to atherosclerosis, calcification of the cusps
pathophysiology of aortic stenosis
increase LV systolic pressure due to narrowing
severe concentric hypertrophy
increased LVEDP
increases oxygen demand leading to ischaemia and LV failure
Aortic Stenosis: Symptoms
Long asymptomatic phase
Cardinal Symptoms
Chest pain (angina)
Syncope/Dizziness (exertional pre-syncope)
Breathlessness on exertion
Heart failure
examination of aortic stenosis
small volume pulse and slowly rising
prominent JVP
vigorous and sustained apex beat
RV heave
things that cause aortic regurgitation
dilated aorta, bicuspid aortic valve, rheumatic heart disease, endocarditis
things that cause aortic regurgitation
dilated aorta, bicuspid aortic valve, rheumatic heart disease, endocarditis
symptoms of aortic regurgitation
chronic- asymptomatic phase and breathlessness
acute0 poorly tolerated as wall tension cannot adapt
