Mitral stenosis Flashcards
(12 cards)
Define mitral stenosis
Mitral valve narrowing causing obstruction to blood flow from left atrium to left ventricle
Main cause of mitral stenosis
Rheumatic heart disease (90%)
Rarer causes of mitral stenosis
5
Congenital mitral stenosis SLE Rheumatoid arthritis Endocarditis Atrial myxoma
Epidemiology of mitral stenosis
incidence
Incidence declining because rheumatic fever is becoming more rare
Presenting symptoms of mitral stenosis
5
May be ASYMPTOMATIC Fatigue Shortness of breath on exertion Orthopnoea Palpitations (related to AF)
Presenting symptoms of mitral stenosis - RARE
3
Cough
Haemoptysis
Hoarseness caused by compression of left recurrent laryngeal nerve by an enlarged left atrium
Signs of mitral stenosis on physical examination
8
Peripheral cyanosis Malar flush Irregularly irregular pulse (if in AF) Apex beat undisplayed & tapping Parasternal heave (due to right ventricular hypertrophy 2º to pulmonary hypertension) Loud S1 w/ opening snap Mid-diastolic murmur Evidence of pulmonary oedema on lung auscultation (if decompensated)
Investigations for mitral stenosis
4 types
ECG
CXR
Echocardiography
Cardiac catheterisation
Investigations for mitral stenosis - ECG
4
May be normal
May see p mitrale (broad bifid p wave cause by left atrial hypertrophy)
May see AF
Evidence of right ventricular hypertrophy may be seen if there is severe pulmonary hypertension
Investigations for mitral stenosis - CXR
4
Left atrial enlargement
Cardiac enlargement
Pulmonary congestion
Mitral valve calcification (occurs in rheumatic cases)
Investigations for mitral stenosis - echocardiography
2
Assesses functional & structural impairments Transoesophageal echocardiogram (TOE) gives better view
Investigations for mitral stenosis - cardiac catheterisation
Measures severity of heart failure
