Condition- Mitral Stenosis Flashcards
What is mitral stenosis
Mitral valve narrowing causing obstruction to blood flow from the left atrium to the left ventricle
Why is the incidence of mitral stenosis falling?
Because of the decline in the incidence of rheumatic fever
What is the main cause of mitral stenosis? List some other rarer causes too
RHEUMATIC HEART DISEASE
- Congenital
- Mucopolysaccharidoses
- prosthetic valve
- SLE
- Rheumatoid Arthritis
- Endocarditis
- Atrial myxoma
List some of the presenting symtpoms of mitral stenosis
- May be ASYMPTOMATIC
- APEX
- AF
- Palpitations/ chest pain
- Exertional dyspnoea (+orthopnoea)
- Xtreme tiredness= Fatigue
- Resp symtpoms: chronic bronchitis type
- Cough
- Haemoptysis
- Hoarseness caused by compression of left laryngeal by enlarged LA
List some of the signs of Mitral stenosis on auscultation
- Loud S1 with opening snap (stiffened valves open with a snap)
- Mid-diastolic murmur- accentuated when lying left lateral on expiration
- Loud P2 (sign of pulmonary hypertension)
- bibasal creps
List some signs of mitral stenosis on physical examination
- Peripheral cyanosis
- Malar flush (decreased CO)
- AF pulse
- Low volume pulse
- Raised JVP + ascites + bibasal creps
- Apex beat UNdisplaced + tapping
- Parasternal heave (right ventricular hypertrophy 2o to pulmonary hypertension)
- Mid-diastolic murmur heard best in left lateral
- Loud S1 with opening snap
Which investigation can be used to definitively diagnose Mitral Stenosis?
Echocardiogram = hockey-stick shaped mitral deformity
Oftem to transoesophageal= better picture
What might you see on a CXR of a patient with Mitral Stenosis
- double right heart border= enlarged left atrium
- cardiac enlargement
- pulmonary oedema- Kerley B lines
- prominant pulmonary artery
- Mitral valve calcification
What might you see on an ECG of a patient with Mitral Stenosis?
- May be Normal
- May see p mitrale (left atrial hypertrophy)
- May see AF
- Evidence of left ventricular hypertrophy if severe pulmonary hypertension
