Wednesday, 16 September 2009

Mitral regurgitation



The most common cause is: Rheumatic heart disease

Other causes include:

Degenerative mitral valve disease

Left ventricular dilatation

Mitral valve prolapse

Papillary muscle dysfunction

Infective endocarditis

Hypertrophic cardiomyopathy

Connective tissue disease

Congenital

Symptoms

  1. Dyspnoea
  2. Fatigue
  3. Palpitation
  4. Odema/ascites

Signs

  1. AF/atrial flutter
  2. Apical PSM+thrills
  3. Soft S1 ,apical S3
  4. Pul venous congestion
  5. Pul hypertension
  6. Jerky pulse

Investigation

1-ECG

AF

Left atrial hypertrophy

Left ventricular hypertrophy

2-CXR

Enlarge left atrium

Enlarge left ventricle

Pul venous congestion

Pul odema

3-echo

Dilated LA/LV

Dynamic LV

Structural abnormality of the mitral valve

Management

Medical:

Duretics

Vasodilator

Warfarin/digoxin

Antibiotic prophylaxis

Surgical:

Signs of progressive left ventricular dilatation.

1-moderate to severe symptoms despite medical therapy provided left ventricular function is adequate

2-ejection fraction <55%

3-Left ventricular end diastolic dimension >45mm, even in absence of symptoms.

Signs of severity

1-dilated left ventricular→displaced thrusting apex

2-S3→indicator of poor prognosis

3-Rt vent function reduced

8 comments:

  1. i tot the EF is <60%?

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  2. I have my exam at Harrogate next week. If anyone has experience of this centre I'd really appreciate it.

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  3. Hi anyone given exam in Walsall Manor hospital can you please share your experiance and cases. Please also tell about sta5,History,communication skills and clinical cases. I will be very grateful. Thanks in advance.

    ReplyDelete
    Replies
    1. Hello!
      Could you please share your experience in Paces in Manor Walsall Hospital please? I have my exams in October . Thank you very much indeed in advance!

      Delete
    2. Hello
      Could you please share your experience in paces exam in walsall manor hospital

      Delete
  4. I am a medical resident on cardiology and I also wrote a few words about mitral regurgitation.

    ReplyDelete
  5. Hello, has anyone given their exams in Manor Walsall Hospital ? Thank you very much

    ReplyDelete
  6. hello, any one given exam in walsall manor hospital ? please can you share your cases

    ReplyDelete