12510617
Descripción
Fichas por Ashutosh Kumar, actualizado hace más de 1 año
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Creado por Ashutosh Kumar
hace casi 7 años
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| Pregunta | Respuesta |
| Mitral stenosis: Aetiology: Presentation: Features: ECG features: CXR changes: ECHO | Aetiology: Rhematic HD (99%), calcification in end-stage renal failure. Presentation: Symptoms: LHF (orthopnoea, dyspnoea, PND, coughing up blood-tinged, frothy sputum or frank haempotysis), RHF (fatigue, weakness), AF (palpitations and embolic events). Features: T: Mid diastolic, louder end of diastole when atria contracts against stenotic valve I:1-4 P: Apex P: On left hand side & expiration (bell) Q: Rumbling (low pitched) R: None S: Mitral faecies, tapping apex beat, opening snap of S1 Later in the disease pulmonary hypertension causes pulmonary regurgitation (Graham steell murmur) and reduced cardiac output causing quiet S1 and early diastolic murmur of P2. ECG features: P mitrale (bifid P w waves, >120 ms), AF later in the disease. CXR changes: Double shadow on right side of heart due to enlarge LA next to RA, straightening of Left heart border ,pulmonary venous congestion. TTE: Measure orifice size, valvular leaftlet thickening, degree of calcification and continuous wave doppler to measure drop in pressure and mean pressure. TOE: Detect left atrial thrombs and calculate W |
| Mitral regurgitation: Aetiology: Presentation: Features: ECG features: CXR changes: DDx: Medical Rx: | Aetiology: MITRAL: Marfarn syndrome, infective endocarditis, tensor apparatus (papillary muscle) dysfunction, RHD, Autoimmune causes, LVH. Presentation: SOB, fatigue, CHF Features: T: Pansystolic I: 1-6 P: Apex P: Q: Blowing R: Axilla S: Thrusting, displaced apex ECG features: AF, ventricular ectopic beats CXR changes: Cardiomegaly, cardiac failure DDx: Ventral septal defect, tricuspid regurgitation Medical Rx: AF Rx and coagulation, diuretics, ACEi (hypertension worsen MR) |
| Aortic stenosis Aetiology: Presentation: Features: ECG features: CXR changes: DDx: Medical Rx: | Aetiology: RHD, calcified bicuspid valve, calcified tricuspid valve Presentation: SOB, syncope and angina (Triad). Features: T: Ejection systolic I: 1-6 P: Aortic P: - Q: Crescendo-decrescendo R: Carotids S: Heaving apex, slow rising pulse, narrow pulse pressure ECG features: LVH CXR changes:- DDx: Hypertrophic obstructive cardiomyopathy, aortic sclerosis Medical Rx: - |
| Aortic regurgitation: Aetiology: Presentation: Features: ECG features: CXR changes: DDx: Medical Rx: | Aetiology: SCREAM- syphilis, congenital, RHD, rheumatoid arthritis, endocarditis, aortic dissection, ankylosing spondylitis, Marfan's syndrome. Presentation: SOB & fatigue (often asymptomatic) Features: T: Early diastolic I: 1-4 P: LLSE P: Sitting up and expiration Q: Breath-like (high pitched) R: None S: Collapsing pulse, widened pulse pressure, thrusting apex, eponymous signs ECG features: CXR changes: Cardiomegaly DDx: Pulmonary regurgitation Medical Rx: Diuretics and vasodilators |
| Tricuspid regurgitation: Aetiology: Presentation: Features: ECG features: CXR changes: DDx: Medical Rx: | Aetiology: Secondary to right ventricular dilatation/infarction, RHD, infective endocarditis. Presentation: RHF signs Features: T: Holosystolic I: 1-6 P: 5th ICS, LSE P: - Q: Blowing R: - S: RHF signs (Elevated JVP, Peripheral edema, pulsatile liver) ECG features: CXR changes: RHF DDx: Medical Rx: Diuretics |
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