Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
21 Cards in this Set
- Front
- Back
|
What is the pattern of the pathophysiology with mitral stenosis?
|
1. Differential pressures in the atria in ventricle
2. Pressure+volume buildup in LA-->pulmonary edema-->dyspnea, hemoptysis, pulmonarh HTN 3. Enlargement of LA |
|
|
What is the area of a normal mitral valve? Symptomatic?
|
4.0 cm^2
1.5 cm^2 |
|
|
Where is mitral stenosis most common? Why?
|
Poorer countries
Can't treat strep aggressively like we do here...rheumatic fever more common--> mitral valve disease |
|
|
What are the clinical features of mitral stenosis?
|
A-fib
Hemoptysis Embolism |
|
|
What are the features of mitral stenosis on physical exam?
|
diastolic murmur
Split S2 |
|
|
How should you be listening to murmur of mitral stenosis?
|
Quiet room
Left lateral decubitus |
|
|
What is a sign of mitral stenosis on EKG?
|
M shaped P wave
M and M! |
|
|
What is the best diagnostic test for mitral stenosis?
|
Echo
|
|
|
What are signs of mitral stenosis on echo?
|
Enlarged RV
Thick anterior leaflet of the valve; hockey-stick appearance Enlarged LA Fish-mouth appearance of the valve |
|
|
What is the medical management for mitral stenosis?
|
Penicillin
Rate control for A-fib: beta blockers, digoxin anticoagulents Diuretics |
|
|
What is the risk for stroke in px. untreated with anticoagulents who have mitral valve disease?
|
80%!!!
YOU CANNOT MISS THIS! YOU ARE GOING TO KILL/DEBILITATE SOMEONE IF YOU DO! |
|
|
What are the invasive options for mitral stenosis?
|
Open surgery: better - can completely open/replace the valve
Catheter opening: can only open it to 2 cm; not everyone qualifies (if too much calcification) |
|
|
What are some of the causes of mitral regurgitation?
|
Calcification of the annulus
Leaflet problems Rupture of the chordae tendinae Papillary muscle dysfunction Dilitation of the LV |
|
|
What is the pathophysiology of Mitral Regurgitation?
|
Increased LA pressure, volume due to the regurgitation--> 2ndary pulmonary edema
|
|
|
What are the clinical features of mitral regurgitation?
|
If mild, asymptomatic
Fatigue Dyspnea PE: Lateral, dynamic LV apex beat Diminished s1 Apical systolic murmur Holosystolic murmur to axilla |
|
|
What are the differences between the murmurs of mitral stenosis and mitral regurgitation?
|
Stenosis: diastolic
Regurgitation: systolic - holosytolic |
|
|
What is the definitive test for mitral regurgitation? Findings?
|
Echocardiogram
Left atrial enlargement LV enlargement Doppler shows regurgitation |
|
|
If a man with a longstanding holosystolic murmur develops acute pulmonary edema, what should you think?
|
Mitral valve prolapse
|
|
|
What is a common cause of acute papillary muscle rupture?
|
MI of myocardium near papillary muscle
|
|
|
What are more chronic causes of papillary muscle dysfunction?
|
enlargement of the LV
|
|
|
When should you replace a regurgitant mitral valve?
|
LV EF < 60%
|
