Cardio - Mitral Regurgitation Flashcards Preview

Year 3 - Medicine Block 1 > Cardio - Mitral Regurgitation > Flashcards

Flashcards in Cardio - Mitral Regurgitation Deck (10)
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1
Q

suggest possible risk factors for MR

A
  • female gender
  • low BMI
  • increasing age
  • prior MI
  • prior mitral stenosis or mitral valve prolapse
2
Q

what is the difference between primary and secondary MR?

A

Primary = intrinsic lesions affect 1 or several components of the MV.

Secondary (functional) = valve leaflets and chordae are structurally normal but MR results from distortion of subvalvular apparatus, secondary to LV enlargement and remodelling.

3
Q

name examples of acute MR causes

A
  1. rheumatic fever (early presentation)
  2. infective endocarditis
  3. papillary muscle rupture (post-MI)
  4. chordal rupture/leaflet flail (MVP, IE)
4
Q

name examples of chronic primary MR causes

A
  1. myxomatous degeneration and MVP (most common)
  2. MVP secondary to Marfan or Ehler’s Danlos syndrome
  3. mitral annulae calcification
  4. congenital heart disease (leaflet cleft, AV canal)
  5. HOCM with SAM
5
Q

name examples of chronic secondary MR causes

A
  1. post-MI LV remodelling
  2. dilated cardiomyopathy (ischaemic or non-ischaemic)

Abnormal dilated LV causes papillary muscle displacement… leaflet tethering with associated annular dilation… prevents coaptation.

6
Q

describe the pathophysiology and presentation of chronic MR

A
  1. Compensated MR: increased volume in LA causes eccentric hypertrophy of LV to maintain normal pressures/stroke volume
  2. decompensated MR: decreased LV stroke volume (unclear why)… LV dysfunction and LV dilation… way worsen MR.

Causes symptoms and signs of HF.

7
Q

describe the pathophysiology and presentation of acute MR

A

Regurgitant volume causes a volume and pressure overload of the LV and LA - increased pressure causes backup of blood in pulmonary system… pulmonary oedema.

Severe symptoms: dyspnoea, orthopnoea, PND +/- cardiovascular collapse and shock

8
Q

which Ix would you perform on someone with suspected MR?

A
  1. Echo: to confirm Dx and assess severity (grade defined by regurgitant jet into LA).
  2. ECG: may show broad P wave of LA enlargement.
  3. CXR: may show LA and LV enlargement.
9
Q

how are most MR pts managed?

A

Valve repair (the sooner the better as prognosis worsens once pts become symptomatic).

10
Q

suggest possible complications of MR

A
  1. pulmonary HTN
  2. LV dysfunction of HF
  3. AF +/.- thrombolic events