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5 Cards in this Set
- Front
- Back
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Pulmonary Stenosis
- Clinical sx |
- Raised JVP w giant a waves
- L) parasternal heave - Thrill in pulm area - Auscultation: ejection systolic murmur in pulm area, widely split S2 due to delay in RV emptying |
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Pulmonary Stenosis
- Additional sx |
- RVF: ascites + peripheral oedema
- Tetralogy of Fallot - Other mumur (commonly TR + VSD) |
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Pulmonary Stenosis
- Ix |
ECG: p-pulmonale, RVH + RBBB
CXR: oligaemic lung fields, large RA TTE: gradient calculation |
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Pulmonary Stenosis
- Mx |
Pulmonary valvotomy if gradient >70mmHg or RV failure
Percut. pulmonary valve implantation Surgical repair/replacement |
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Carcinoid syndrome
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- Gut primary w liver mets secreting 5-HT into systemic circulation
- Toilet sx: diarrhoea, wheeze, flushing! - Secreted mediators scar and thicken right-sided heart valves resulting in TR and/or Pulm stenosis - RARELY a bronchogenic primary tumour can release 5-HT into the systemic circulaion and cause L) sided scarring |
