Loading....
Coupon Accepted Successfully!

Medicine

Open Flashcards

Cardiology

Question
6 out of 30
 

Which of the following is a cause of MR?



A Rupture chordae tendinea

B Papillary muscle dysfunction

C Congenital

D All of the above

Ans. D

All of the above

Mitral Regurgitation

Causes:


1. Functional (LV dilatation)

2. Annular calcification (elderly)

3. Rheumatic fever & RHD

4. Infective endocarditis

5. Mitral valve prolapse

6. Rupture chordae tendine

7. Papillary muscle dysfunction/rupture

8. Connective tissue disorder\ (Ehlers-Danlos, Marfan’s)

9. Congenital (may be associated with other defects. eg ASD, AV canal)


Pathophysiology –

In acute MR – There is normal/ reduced compliance of LA leading to marked increase in

LA pressure – pulmonary edema

In chronic MR –

There is increase in LA compliance – normal / only slightly elevated LA pressure – decrease CO.

Hence in chronic MR fatigue/ exhaustion are common while symptoms

Resulting from pulmonary congestion are less common.

Symptoms:

Easyfatigability Q; (commonest symptom), palpitations, Dyspnea.

Signs: -displaced, hyperdynamic apex; RV heave; soft S1Q; loud P2 Q (pulmonary hypertension)

pansystolic murmur Qat apex radiating to axilla.

Tests:

ECG: Af +, P-mitrale if in sinus rhythm (It means left atrial enlarge size); LVH

CXR:big LA & LV; mitral valve calcification; pulmonary oedema.

Echocardiogram assess LV function (trans-oesophageal to assess severity and suitability for repair rather than replacement). Doppler echo to assess size and site of regurgitant jet.


Complication

1. Atrial fibrillation

2. Infective endocarditis – More common than in MS

Management:

1. Diuretics improve symptoms.

2. Antibiotics to prevent endocarditis

3. Digoxin if in heart failure or Af. Control rate if fast AF.

4. ACEI

5. Anticoagulated if: AF; history of embolism prosthetic valve; additional mitral stenosis.


Surgical – Surgery for deteriorating symptoms; aim to repair or replace the valve before LV irreversible impaired.

Mitral valve replacement – Done in

1. Severe, symptomatic MR (class II, III, IV)

2. Asymptomatic MR with LV dysfunction, i.e. LVEF <55%

Cardiology Flashcard List

30 flashcards
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
14)
15)
16)
17)
18)
19)
20)
21)
22)
23)
24)
25)
26)
27)
28)
29)
30)