Cardiac output leads to elevated left atrial pressure

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Unformatted text preview: ssure Raised pulmonary venous and capillary Raised pressures pressures Increased heart rate increases pulmonary Increased pressures pressures 2 Mitral stenosis Mitral stenosis Presentation Dyspnea, fatigue, low exercise tolerance fatigue low Palpitations Haemoptysis – due to pulmonary Haemoptysis oedema oedema Systemic embolism – clots will come Systemic from left atrium from Infective endocarditis Infective Mitral stenosis Mitral stenosis Clinical signs Pulse is normal or low volume LV not enlarge, LA dilates Normal sized heart heart Loud S1 Loud S1 Loud P2 Pulm HTN Loud P2 Mid diastolic murmur at apex apex Opening snap Mitral Stenosis Mitral Stenosis Treatment Medical • • • • • Avoid tachycardia, fever, vigorous exercise Atrial Treat atrial fibrillation Atrial fib pulm edema, etc atrial fib Diuretics ↑Diastole time - chronotropic Chronotropic agents (beta blockers, digitalis) digitalis I.E. prophylaxis Surgical • Balloon angioplasty, closed commisurotomy angioplasty closed • Valve replacement 3 Aortic regurgitation Aortic regurgitation Causes Supravalvular (aortic root disease) • Marfan’s, Aneurysm, Syphilis, connective tissue diseases Aneurysm Syphilis diseases Valvular • • • • • • Congenital- Bicuspid aortic valve, large VSD Bicuspid large VSD Connective tissue Diseases Connective Diseases Rheumatic fever. I.E heumatic ever. I.E Myxomatous degeneration Trauma Aortic Dissection Aortic Dissection Aortic regurgitation Aortic regurgitation Physiology Increased diastolic run off Volume overload ume overload LV dilatation Wide pulse pressure pulse press Cardiac Cycle Cardiac Aortic regurgitation Aortic regurgitation Symptoms Dyspnea, orthopnea, PND, fatigue and orthopnea, palpitations palpitations Angina-like pain Signs • High volume pulses volume pulses • Heaving apex • Early diastolic murmur • (location depends on the cause of the (location murmur murmur Signs of severe AR Signs Quincke’s sign-capillary pulsations Traube’s sign- pistol shot femorals De Musset’s sign-Head bobbing Corrigan’s pulses Collapsing pulses Mueller’s sign-systolic pulsations of the Mueller’s uvula uvula Aortic Regurgitation Aortic Regurgitation Treatment Asymptomatic • Monitor, nifedipine, ACE inhibitors Monitor, nifedipine ACE Medical Medical • Restrict activities • Treat CHF- digoxin, furosemide digoxin, Surgical • Chronic AR with symptoms and LV dysfunction symptoms • Acute ,severe AR with hemodynamic instabili...
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