Investigations of Lesions

Question 1

Mitral Regurgitation

Answer 1

ECG: LVH, pmitrale, AF
CXR: cardiomegaly, pulm oedema, double density splayed carina
Echo: to identify type of MR by leaflet to determine if degen/functional, EF to assess for surgery
Indications for surgery:
if NYHA III sx despite GDMT,ero >0.4cm2

Question 2

Aortic regurgitation

Answer 2

ECG: heart block, LVH
CXR: calcified valve,cardiomegaly, aortic dilatation
Echo: mean gradient >50mmHg
Operate when LVESD >5.5cm, dyspnea on exertion

Question 3

Astenosis

Answer 3

ECG: LVH
CXR: calcified valve
Echo mean gradient >50mmHg, /lvh
Operate when valve area <0.7cm2/m2

Question 4

Mitral stenosis

Answer 4

ECG: pmitrale, AF, RAD
CCXR: mitral valve calcification
enlarged left atrium,  valve area
positoon of posterior mitral leaflet (ant in diastole)
Operate when valve area< 1cm2

Question 5

HOCM

Answer 5

Assymetric hypertrophy of vent septum

systolic anterior motion of ant mitral valve leaflet