University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

89

Pages:

2
Author:

Mariam A. A.

Mitral Valve Stenosis Definition Decrease in the cross-sectional area of the mitral valve -> leaflets fuse together Aetiology • • • Rheumatic fever Degenerative aortic stenosis Lupus erythematosus Pathophysiology Cause present -> leaflets fuse together -> commissural fusion -> normal valve opening (4-6 cm reduced to cm) -> harder for blood to flow from LA to LV -> blood volume increases in LA -> increase in pressure -> higher pressure flowing through a fibrotic valve make a snap sound when it opens -> diastolic rumble as blood is forced through the smaller opening -> constant elevation in blood volume and blood pressure -> left atrium dilation -> muscle walls stretch -> pacemaker cells that run through the walls become more irritable -> increased risk of atrial fibrillation -> left and right atrium can’t contract effectively -> blood becomes stagnant -> blood clots Signs and Symptoms • • • • • • • • Blood backing into systemic circulation: - Compressed oesophagus -> dysphagia - Pulmonary congestion and edema -> dyspnoea Fatigue Palpitations Orthopnoea Haemoptysis Loud S1 Diastolic murmur Chest pain Diagnosis • • • Physical examination - Loud S1 - Diastolic murmur - Shorter interval between S2 and opening snap ECG - Usually, normal - Atrial fibrillation - Right ventricle hypertrophy - Left atrial enlargement - P wave mitrale Chest X ray • - Determines if there is any enlargement Transthoracic echocardiogram - Transducer is placed on the top of the anterior chest wall and the epigastrium - Enables the visualisation of the heart’s chambers, valves, ascending aorta and the pericardium Treatment • • • Meds - Heart rate decreasing meds, beta blockers, Ca2+ blockers tec. - Diuretics - Blood thinners - Anti-arrythmias - Anti-coagulants Mitral valve replacement Percutaneous mitral valve balloon commissurotomy - A balloon is advanced into the target valve and inflated stretching open the stenotic valve in the process Complications • • • • Atrial fibrillation Congestive heart failure Enlarge left atrium Progressive congestion if the lungs, pulmonary edema, pulmonary hypertension