264 Mitral Regurgitation

Question 1

in acute MI, what muscle is involved much more frequently causing acute MR

Answer 1

Question 2

differentiate primary vs secondary MR

Answer 2

Question 3

MR may occur as a congenital anomaly,
most commonly as a defect of…

Answer 3

the endocardial cushions

Question 4

Similar mechanisms of annular dilation and ventricular remodeling contribute to the MR that occurs among patients with nonischemic forms of dilated cardiomyopathy once the LV end diastolic dimension reaches HOW MANY cm

Answer 4

6cm

Question 5

Which is more common cause of secondary MR…. LV remodelling or AF/annular dilation?

Answer 5

Secondary MR due to LV remodeling is more frequently encountered in the community than secondary MR that occurs in association with AF and annular dilation.

Question 6

Irrespective of cause, chronic severe MR is often progressive because enlargement of the left atrium (LA) places tension on the (ANTERIOR OR POSTERIOR?) mitral leaflet, pulling it further away from the mitral orifice and thereby aggravating the valvular dysfunction.

Answer 6

Irrespective of cause, chronic severe MR is often progressive because enlargement of the left atrium (LA) places tension on the posterior mitral leaflet, pulling it further away from the mitral orifice and thereby aggravating the valvular dysfunction.

Question 7

LV afterload is reduced in patients with MR. True or False?

Answer 7

True

Question 8

What is the initial compensation to MR

Answer 8

The initial compensation to MR is more complete LV emptying.

Question 9

ejection fraction (EF) rises in severe MR in the presence of normal LV function. True or False

Answer 9

True

Question 10

Chronic, severe MR is defined by (3 parameters)

Answer 10

Question 11

Describe the murmur of acute MR in terms of timing, configuration, and ed

Answer 11

Question 12

V wave in acute vs chronic MR

Answer 12

acute MR : v wave prominent

chronic MR: v wave LESS prominent

Question 13

Describe the murmur of chronic MR

Answer 13

classically holosystolic in timing and plateau in configuration, as a reflection of the near-constant LV-LA pressure gradient

Question 14

Symptoms of chronic MR (mild/mod) vs severe chronic MR

Answer 14

Question 15

Differentiate acute vs chronic MR in terms of ARTERIAL PRESSURE

Answer 15

Question 16

Differentiate acute vs chronic MR in terms of apical impulse

Answer 16

Question 17

Characteristic of S1 in MR

Answer 17

Question 18

What causes the wide but physiologic splitting of S2

Answer 18

Question 19

when does low pitched S3 occur in MR

Answer 19

Question 20

cause of low pitched S3 occur in MR

Answer 20

Question 21

most characteristic auscultatory finding in chronic severe MR.

Answer 21

Question 22

differentiate the murmur of acute vs chronic MR in terms of configuration

Answer 22

Question 23

The systolic murmur of chronic MR
is usually most prominent at WHAT PART OF HEART

Answer 23

The systolic murmur of chronic MR
is usually most prominent at the apex and radiates to the axilla

q

Question 24

The systolic murmur of chronic MR
is usually radiates to WHAT BODY PART

Answer 24

The systolic murmur of chronic MR
is usually most prominent at the apex and radiates to the axilla

q

Question 25

in patients with ruptured chordae tendineae or primary involvement of the posterior mitral leaflet with prolapse or flail, WHERE IS THE DIRECTION OF THE REGURGITANT JET

Answer 25

Question 26

Differentiate the quality of murmur due to ruptured chordae tendinea VS flail leaflet

Answer 26

Question 27

What mechanisms / movements intensify VS reduce the systolic murmur of chronic MR not due to MVP

Answer 27

Question 28

q

dominant chambers in chronic MR

Answer 28

LA and LV

Question 29

chamber of the heart that forms the right border of the cardiac silhouette later in the course of MR

Answer 29

LA

Question 30

Calcification of the mitral annulus may be visualized, particularly on what CXR view

Answer 30

lateral view of the chest

Question 31

Patients with acute severe MR may have asymmetric pulmonary edema if the regurgitant jet is directed WHERE

Answer 31

predominantly to the orifice of an upper lobe pulmonary vein

Question 32

in general, what anticoagulants can be given for px with MR

Answer 32

Question 33

in MR, direct oral anticoagulants (e.g., apixaban, rivaroxaban) should not be used if with either of these 2 conditions…

Answer 33

Question 34

there is a role for vasodilators in both acute and chronic MR . True or False

Answer 34

False

Question 35

When is antibiotic prophylaxis for prevention of IE indicated for MR patients….

Answer 35

Antibiotic prophylaxis for prevention of IE is indicated for MR patients with a prior history of IE.

Question 36

Asymptomatic patients with severe MR in sinus rhythm with normal LV size and systolic function should avoid what TYPE/FORM of exercise

Answer 36

isometric forms of exercise

Question 37

Indicatiosns for surgery in MR (5)

Answer 37

Question 38

When surgical treatment is contemplated, THESE PROCEDURES (2) may be helpful in confirming the presence of severe MR in patients in whom there is a discrepancy between the clinical and TTE findings that cannot be resolved with TEE or CMR.

Answer 38

left and right heart catheterization and left ventriculography

Question 39

2D echo Parameters for severe (4)

Answer 39