Содержание
- 37. Natural History of Mitral Regurgitation With acute mitral regurgitation, left atrial compliance is predominantly fixed; therefore
- 38. Chronic Mitral Regurgitation Patients with chronic mitral regurgitation will have a long latent period before becoming
- 39. Mitral Regurgitation hemodynamics In patients with significant mitral regurgitation, prominent v-waves are seen on the left
- 40. Symptoms Fatigue & weakness – due to ? CO – predominant complaint Exertional dyspnea & cough
- 41. Sings Atrial fibrillation Cardiomegally Apical pansystolic murmur +/- thrill Soft S1, apical S3 Signs of pulmonary
- 42. escardio.org 2017
- 43. Rick A. Nishimura et al. Circulation. 2014;129:2440-2492
- 45. Type IIIb (restricted leaflet closing) ▪ Regional/global LV dysfunction ▪ LV & Papillary muscles geometry changes
- 46. MitraClip device
- 49. Mitral Stenosis
- 50. Mitral Stenosis Etiologies: Rheumatic valvular disease - the most common cause of mitral stenosis. Congenital deformities
- 51. Rheumatic Valvular Disease Rheumatic fever is a collagen vascular disorder which occurs following group A beta-hemolytic
- 52. Rheumatic Mitral Stenosis
- 53. Acute Rheumatic Fever: Modified Jones’ criteria Major Carditis (Myocarditis, pericarditis, valvulitis) Polyarthritis Sydenham’s chorea Subcutaneous nodules
- 54. Acute Rheumatic Fever: Presentation
- 55. Acute Rheumatic Fever: Some clinical signs Erythema marginatum
- 56. Acute Phase Chronic Phase valve leaflet inflammation can result in transient regurgitant murmurs and mid diastolic
- 57. Mitral Valve Stenosis: Sings Palpation: Small volume pulse Tapping apex-palpable S1 Palpable S2 Atrial fibrillation Signs
- 58. Hemodynamics of MS Left ventricular pressure rises above left atrial pressure in early systole causing the
- 59. Mitral Valve Stenosis HEMODYNAMICS
- 60. What is the impact of chronic elevation in left atrial pressures on the remainder of the
- 61. With mitral stenosis, there is impedance to left atrial emptying. Left atrial pressure rises to maintain
- 62. With ongoing passive congestion, reactive vasoconstriction occurs in the pre-capillary beds (“pre-capillary block") causing additional increases
- 63. Precapillary Block Fatigue Exhaustion Weakness Tiredness Right-sided failure Edema, hepatomegaly Tricuspid insufficiency Cyanosis(peripheral) Large heart Mild
- 64. With ongoing passive congestion, reactive vasoconstriction occurs in the pre-capillary beds (“pre-capillary block") causing additional increases
- 65. Mitral Valve Stenosis: Symptoms Dyspnea and cough (pulmonary vascular congestion and pulmonary hypertension) Orthopnea (related to
- 66. Auscultatory findings With a structurally normal mitral valve, there is no significant LA to LV diastolic
- 67. With mild mitral stenosis, left atrial pressure is elevated creating a LA to LV pressure gradient
- 68. As mitral stenosis increases in severity, left atrial pressure continues to rise to a point where
- 69. S1 S2 OS S1 First heart sound (S1) is loud and snapping Opening snap (OS) Low
- 70. Mitral Valve Stenosis: Pathophysiology Normal valve area: 4-6 cm2 Mild mitral stenosis: MVA 1.5-2.5 cm2 Minimal
- 71. Chest XR
- 72. Type IIIa (restricted leaflet opening) Domelike anterior leaflet movement, restriction of posterior leaflet subvalvular fusions
- 73. Rick A. Nishimura et al. Circulation. 2014;129:2440-2492
- 74. Rick A. Nishimura et al. Circulation. 2014;129:2440-2492
- 75. Rick A. Nishimura et al. Circulation. 2014;129:2440-2492
- 76. Rick A. Nishimura et al. Circulation. 2014;129:2440-2492
- 77. Percutaneous balloon valvuloplasty Carpentier A. “Reconstructive valve surgery” 2010
- 78. Percutaneous balloon valvuloplasty
- 79. Mitral Valve Repair Carpentier A. “Reconstructive valve surgery” 2010
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