Mitral Stenosis - Blonder SRS Flashcards Preview

Cardiovascular II Exam 3 > Mitral Stenosis - Blonder SRS > Flashcards

Flashcards in Mitral Stenosis - Blonder SRS Deck (18):
1

What is clinically significant MS due to in the adult?

Only caused by inactive rheumatic heart disease in the adult.

2

Although not of great significance, what else can rarely cause mitral stenosis?

Mitral annular calcifications can lead to MS - largely due to aging process.  

3

Rheumatic fever is a disease of?

Childhood and young adults, particularly in populations deprived of antibiotics (3rd world, abused populations, etc)

 

4

Rheumatic heart disease affects what proportion of patients with RF?

1 in 3

5

How often is the mitral valve involved in RHD?

NEarly 100% of the time

6

What are the valvular presentations we see with rheumatic heart disease?

40% have isolated MV involvement

40% have MV and aortic involvement

20% have MV, Aortic valve, and tricuspid valve involvement

 

7

What organism causes RF?

Group B strep

8

What are the symptoms of RHD?

  1. DOE (dyspnea on exertion)
  2. PND (paroxysmal nocturnal dyspnea)
  3. Orthopnea
  4. fatigue
  5. hemoptysis
  6. atrial fibrillation
  7. thromboembolism
  8. chest pain (from pulmonary HTN)

 

9

What are the symptoms in Mitral stenosis due to?

Symptoms are due to the obstruction of flow from the LA to the LV through the MV. This increases the pressure in the LA, pulmonary vasculature back into the RV and RA. It is the resistance to blood flow that increases the pressure.; The heart always tries to maintain the flow (CO), and thus the pressure rises secondarily.

10

A very common sequalea of MS, atrial fibrillation reduces CO by two mechanisms.  What are they?

 

What can this precipitate?

  1. Loss of atrial contribution to LV filling
  2. Increase in HR both of which reduce LV filling

 

Can frequently precipitate APE (acute pulmomary edema)

11

What does the patients face look like in MS?

•Mitral facies-pink purple cheeks (maxillary) from decrease in CO and vasoconstriction

12

Describe the auscultation findings in mitral stenosis

•Increased S1

•Single S2

•Opening Snap, follows S2, severe shortens the A2-OS interval

•Mid diastolic murmur (rumble), heard at apex, with pre systolic accentuation (if in NSR).

13

If the opening snap of the mitral valve comes a long time after the A2 sound (long A2 - OS interval), then?

severe MS

14

What will you hear at the apex of the heart in a patient with mitral stenosis?

Exam topic

Middiastolic murmur (rumble), with presystolic accentuation

15

What else can cause a diastolic murmur in mitral stenosis?

Also a test question

Pulmonary HTN caused pulmonic valve insufficiency.

16

What will you see on chest x-ray in MS?

•CXR-LAE, RVH, pulmonary congestion, enlarged PA (hypertension)

17

What is the gold standard for MS diagnosis?  What components matter?

•Echocardiography is now the gold standard.

  • PA pressures,
  • mitral gradients (mean and peak),
  • CO,
  • SV
  • MVA are all standard.

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