Mitral Stenosis Flashcards

1
Q

what are the causes of MS?

A

Essentially rheumatic cause

rarely congenital

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2
Q

what happens in rheumatic causes?

A

get an immune complex forming, leading to inflammation of the valve. You get stiffening and thickening

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3
Q

rheumatic heart disease is much more common in _____-

A

women

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4
Q

The pathological process results in valve _____, cusp ___, calcium ______, a narrowed (stenotic) valve ____.

A

The pathological process results in valve thickening, cusp fusion, calcium deposition, a narrowed (stenotic) valve orifice.

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5
Q

in order for CO to be maintained the ___ _____l pressure increases and left atrial ______ and _____ occur.

A

in order for CO to be maintained the left atrial pressure increases and left atrial hypertrophy and dilatation occur.

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6
Q

what happens as a result of the increased left atrial pressure?

A

pulmonary venous, arterial pressure and right heart pressures also increase.

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7
Q

what does the increase in pulmonary pressure lead to?

A

pulmonary oedema

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8
Q

Pulmonary hypertension leads to RV ______, dilatation and ______

A

Pulmonary hypertension leads to RV hypertrophy, dilatation and failure

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9
Q

Right ventricular dilatation results in ______ regurgitation

A

Right ventricular dilatation results in tricuspid regurgitation

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10
Q

what are the symptoms of MS?

A
  • breathlessness
  • fatigue
  • palpitations
  • pink frothy sputum
  • symptoms due to RHF
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11
Q

which arrhythmias commonly occur?

A

AF

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12
Q

what can AF lead to ?

A

systemic emboli

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13
Q

why do people get breathless?

A

because of pulmonary venous hypertension and recurrent bronchitis

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14
Q

what are the signs of MS?

A
  • malar flush
  • tapping apex beat
  • small volume pulse
  • a wave jugular vein
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15
Q

what sounds are heard?

A
  • loud s1 and loud P2
  • there is an opening snap
  • as valve cusps become immobile there is a loud S1 and opening snap disappears
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16
Q

when do you see malar flush?

A

only seen in patients with advanced disease who have pulmonary hypertension

17
Q

why is there an opening snap?

A

because of the force of the increased left atrial pressure

18
Q

what does the murmur sound like?

A

mid-systolic rumbling diastolic murmur which is localised to the apex

19
Q

the murmur often isnt heard unless&raquo_space;»

A

you do the manoeuver

20
Q

what do you listen to the murmur with?

A

the bell

21
Q

what might be seen on CXR?>

A

straight left border

22
Q

what investigations should be done

A

ECG

23
Q

what is the treatment?

A

This is a mechanical problem that can only really be fixed with surgery but patient may need no other treatment other than treatment of bronchitis attacks

24
Q

what medication may be required?

A

diuretics and treatment for AF (digoxin and anticoagulation)

25
Q

what might be the complication of surgeyr?

A
  • mitral regurgitation