Mitral and Tricuspid Valve Disease Flashcards Preview

CVPR Unit 1 > Mitral and Tricuspid Valve Disease > Flashcards

Flashcards in Mitral and Tricuspid Valve Disease Deck (26):
1

Forms of valve disease

Regurgitation (Insufficiency)
Stenosis

2

Components of mitral valve

Annulus
leaflets
chordae
Papillary muscle

3

What is the mitral annulus?

Fibrous structure that supports the valve in the atrial ventricular grove. Not planer - hyperbolic paraboloid

4

Describe the shape of the mitral annulus

saddle shaped

5

Possible mitral valve pathology

-Regurgitation: Functional & Myxomatous disease
-Stenosis: rheumatic

6

Primary mitral valve disease

-Myxomatous: associated w/ connective tissue disease, hereditary, results in prolapse, redundancy and valve incompetence
-Endocarditis, chordae rupture

7

Mitral valve prolapse show a Long __________ course

asymptomatic

8

Mitral valve prolapse - sequlae

Left atrial enlargement (Afib)
Left ventricle volume overload (Dilation & dysfunction)
Heart Failure symptoms
Risk of endocarditis

9

What is heard upon auscultation of a mitral valve prolapse pt?

Mid systolic click
Late diastolic or holosystolic murmur (classically in apex)

10

Maneuvers that modify the murmur resulting from a mitral prolapse:

- intensify and prolong the Murmur: Decrease LV size (Valsalva, dehydration)
-decrease murmur: Increase LV size (Squatting, Hydration)

11

Myxomatous mitral valve Treatment

-Surgical treatment: repair or replacement
-Medical treatment: After-load reduction (reduce systemic BP), Treatment of CHF symptoms (diuretics), not very effective

12

causes of functional mitral valve regurgitation?

-Primary a Left ventricle problem:
Restriction of the Leaflets
Tethering of the chordea
Dilatation and flattening of the annulus

13

what physical findings do you find on a Functional Mitral Regurgitation pt?

-Holosystolic murmur at apex: Quiet S1
-Signs of LV dysfunction:
S3, S4
Loud P2 – associated with Pulmonary Hypertension
Lateral displacement of the apical impulse Edema, crackles, Jugular venous distension

14

Functional Mitral Regurgitation Treatment

-Medical Treatment,Treat the underlying cardiomyopathy:
ACEI
Beta-blockers
Spironolactone
Revascularization
Bi-Ventricular Pacing
Transplant
-Primary Mitral Valve Surgery – Controversial

15

what is mitral stenosis?

Restricted opening of the Mitral valve from a chronically thickened valve

16

Major cause of mitral stenosis?

Rheumatic Heart Disease, Rarely senile Calcification

17

Mitral Stenosis -sequlea

-Long asymptomatic period
-Left atrial enlargement (can be massive): a fib, clots, stroke
-Heart failure symptoms
-Pulmonary hypertension

18

physical findings in mitral stenosis?

– Loud S2
– Opening snap
– Diastolic rumble At apex
– Signs of pulmonary hypertension: Loud P2, RV thrill &JVD
Tricuspid regurgitation murmur

19

Treatment of mitral stenosis

-Valvuloplasty
-Surgical replacement
-medical Tx: Not curative
– Beta blockers
– Diuretics (to treat heart failure) – Anticoagulation
– Antibiotics

20

Tricuspid valve anatomy

3 leaflets
3 papillary muscles

21

Types of tricuspid valve disease

-Tricuspid Regurgitation: 2dary to HF or Pulm HTN
-Primary Tricuspid Valve disease is rare
– Congenital heart disease (Epstein’s Abnormality)
– Endocarditis
– Carcinoid
– Rheumatic

22

what is associated with underlying RV disease and pulmonary hypertension?

Tricuspid Regurgitation

23

physical findings of Tricuspid Regurgitation?

-Holosystolic Murmur:
Left lower sternal border
Increases with inspiration
Loud P2 (with pulmonary hypertension)

24

epidemiology of Tricuspid Stenosis

rare, Carcinoid syndrome

25

Tricuspid Stenosis - Sequlea

Right heart symptoms: JVD, edema, hepatic congestion

26

physical findings of tricuspid stenosis

Diastolic murmur at Left lower sternal border – Increases with inspiration