Blonder - Chronic Mitral Regurgitation Flashcards

1
Q

What is the most elusive component of the pathophysiology of mitral valve regurgitation?

A

The transition from compensated to decompensated

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2
Q

Should the EF in a pt with mitral regurg be low, normal, or high?

A

EF should be normal or high due to increased preload from regurgitant valve

Decrease in EF is a major cause for alarm

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3
Q

What are the five components of the mitral valve?

A

Valve leaflets

Mitral annulus

L atrium

Chordae tendinae

L ventricle

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4
Q

What is the most common cause of mitral regurgitation?

A

Myxomatous degeneration of mitral valve

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5
Q

Besides myxomatous degeneration, what are two other causes of mitral regurgitation that affect the leaflets?

A

Rheumatic changes

Subacute bacterial endocarditis

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6
Q

What change(s) to the mitral annulus can cause mitral regurgitation?

A

Calcification

usually not severe

practically impossible to repair surgically

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7
Q

What changes to the chordae tendinae can cause mitral regurgitation?

A

Rupture (usually an acute cause)

Rheumatic fever will fix chordae

Bacterial endocarditis (usually acute)

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8
Q

What changes to the L atrium can cause mitral regurgitaiton?

A

Dilation of the L atrium

Mitral regurg will cause this dilation, making the regurg worse

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9
Q

What are two very good clues of decompensated heart failure?

A

Orthopnea

Paroxysmal nocturnal dyspnea

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10
Q

What is the character of the sound of mitral regurgitation?

A

Blowing holosystolic murmur

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11
Q

What is the medical treatment for mitral regurg?

A

Lower systemic vascular resistance so blood goes where it’s supposed to go

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