Flashcards in Clinica Valvular Heart Disease Deck (21)
What is the predominant cause of mitral stenosis?
What is mitral stenosis?
The thickened leaflets may be so adherent and rigid that they cannot open or shut, reducing or rarely even abolishing the first heart sound
What changes in the heart occur as a result of MS?
LA dilation along with RV and RA dilation
What is the main symptom of MS?
Dyspnea on exertion
What is seen the echocardiogram of MS patients?
"Hockey Stick" abnormality
What are the medical treatments of MS?
- Beta blockers may increase exercise capacity by reducing heart rate in patients with sinus rhythm, but especially in patients with atrial fibrillation.
- Digitalis glycosides for Right HF and atrial fibrillation
- Penicillin prophylaxis for beta-hemolytic streptococcal infections and prophylaxis for infective endocarditis
What are the guidelines for surgical intervention in MS?
It should be carried out in symptomatic patients with moderate to severe MS
What are the surgical treatments for MS?
- MV Replacement
What are the causes of mitral regurgitation?
• Inflammatory –Rheumatic,SLE
• Degenerative - MVP, Marfans, MAC
• Infective Subacute Endocarditis
Where is MR best heard?
In the axilla - it is holosystolic from S1 to S2
What happens to the LV with volume overload?
It will enlarge with NO hypertrophy
What happens to the LV with pressure overload?
It will be normal size with hypertrophy
What is the best pre-op end systolic diameter of the MV?
50 mm or less
What are the symptoms in chronic MR?
Symptoms usually do not develop in patients with chronic MR until the left ventricle fails. By the time that symptoms secondary to a reduced cardiac output and/or pulmonary congestion become apparent, serious and sometimes even irreversible left ventricular dysfunction may have developed.
What is the medical treatment for MR?
Afterload reduction is of particular benefit in the management of MR—both the acute and the chronic forms. An angiotensin inhibitor or oral hydralazine are indicated.
Does valvuloplasty work in aortic stenosis?
No. Usually the calcification with return.
What is the treatment for aortic stenosis?
What is the cause of aortic regurgitation?
Aortic regurgitation (AR) may be caused by primary disease of either the aortic valve leaflets (rheumatic fever) or the wall of the aortic root or both.
What is good medical treatment for AR?
What is the most common cause of tricuspid regurgitation?
The most common cause of tricuspid regurgitation (TR) is not intrinsic involvement of the valve itself but dilatation of the right ventricle and of the tricuspid annulus, which may be complications of right ventricular failure of any cause and which cause secondary, functional TR.