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Medicine

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Cardiology

Question
5 out of 30
 

Reduce EF slope in echo is seen in? (AIPG 2009)



A MS
B MR

C MVP
D None of the above

Ans. A

MS

Tests:

ECG:

1. AF

2. P-mitrale if in sinus rhythm

3. RVH

4. Progressive RAD.

CXR:

1. Straitening of the left border of heart (Earliest feature Q)

2. Pulmonary oedema

3. Prominent upper lobe veins (Colonel moustache sign)

4. Left atrial enlargement

5. Mitral valve calcification.

6. Kerley B lines

Echocardiography diagnostic. Significant stenosis exists if the valve orifice is <1cm2.

Reduced EF slope is characteristic Q. (AIPG 03)

Management;

1. Diuretics to reduce preload and pulmonary venous congestion

2. Digoxin If in AF or in CHF. Rate control is crucial. Anticoagulated with warfarin

3. If this fails to control symptoms, balloon valvuloplasty (if pliable, non-calcified valve), open mitral valvotomy or valve replacement

4. Endocarditis prophylaxis for dental or surgical procedures

5. Oral penicillin as prophylaxis against recurrent rheumatic fever if <30yrs old

Complications

1. Pulmonary hypertension

2. Emboli

3. Pressure from large LA on local structures, eg hoarseness Q (recurrent laryngeal nerve, Ortner’s syndrome Q) dysphagia Q (oesophagus), bronchial obstruction Q

4. Infective endocarditis.

Surgical

4 types of surgery (Hari-18th Pg- 1932)

1. Percutaneous Balloon valvuloplasty

2. Closed mitral valvotomy

3. Open mitral valvotomy

4. Valve replacement

Two types of prosthetic valves –

1. Mechanical prosthesis – Lifelong anticoagulation is indicated for patient receiving mechanical prosthesis. But its life is more than bio prosthesis valve hence preferred in young individuals

2. Bio prosthesis – useful in older individuals (>70yrs) and in pregnancy when risk of anticoagulation is significant.

Cardiology Flashcard List

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