Mitral Stenosis

Question 1

Prevalence?

Answer 1

• SUPER LOW in US bc of low rheumatic fever

- higher in other places

Question 2

Most common cause of mitral stenosis?

Answer 2

-rheumatic fever

Question 3

Whcih gender is most affected by mitral stenosis/rhuematic fever?

Answer 3

females

Question 4

Mild Mitral stenosis is what size compared to nomral?

Answer 4

• normal is 4-6cm^2

- mild=2cm^2

Question 5

critical mitral stenosis is what size compared to normal?

Answer 5

• normal is 4-6cm^2

- critical is 1cm^2 or less

Question 6

what is usually the FIRST SYMPTOM OF MILD+ MITRAL STENOSIS?*

Answer 6

embolization

Question 7

unexplained arterial embolism think?

Answer 7

-mitral stenosis

Question 8

mitral facies:

Answer 8

-people with mitral stenosis have purple-pink cheeks when severe disease – low output and vasoconstriction

Question 9

Physical exam of MS:

Answer 9

• mitral facies
• arterial pulses normal to reduced
• apical impulse is inconspicuous to absent

Question 10

Mitral stensois- auscultation:

Answer 10

• -S1 is LOUD if leaflets still flexible
• *-opening snap heard best at apex
• P2 accentuated as pulmonary artery pressure rises
• S4 is RV (pulmonary HTN)
• Graham Steell Murmur

Question 11

Opening snap present means what about the stenosis?

Answer 11

-the disease isnt severe yet

Question 12

Graham Steell Murmur

Answer 12

• sign of severe pulmonary HTN

- pulmonic insufficiency - dilated pulmonary artery

Question 13

ECG of mitral sten usually shows?

Answer 13

• LA conduction abnormality (dilated L atrium)
• a fib
• RVH

Question 14

General Tx for mitral stenosis

Answer 14

-prophylactic against infective endocaarditis and beta-hemolytic streptococci
-reduce salt and water intake
-maintain sinus rhythm
-use anticoags
no strenuous activity
-treat the atrial fib**
-slow ventricular rate (beta blockers, verapamil, diltiazem, digitalis glycosides)
-valve replacement
-valve balloon valvotomy
-valve closed valvotomy
…