Mitral Valve

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Fichas sobre Mitral Valve, creado por Jimmy B el 26/05/2014.
Jimmy B
Fichas por Jimmy B, actualizado hace más de 1 año
Jimmy B
Creado por Jimmy B hace más de 10 años
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Narrowing of the left atrioventricular valve is... Mitral Stenosis
What are the 2 causes of ms? Rheumatic fever and MAC(mitral annular calcification)
Which type of ms is the most common? Rheumatic fever
MAC can generally be associated with which patient? Elderly
Common clinical S&S of ms (4) Dyspnea upon exertion, Hemoptysis, CP, Murmur
What is hemoptysis? Coughing/Spitting up blood from respiratory tract
What is causing the hemoptysis? Backup of blood flow into the lungs
What is the most common symptom of ms? Dyspnea upon exertion
2nd most common symptom of ms? Hemoptysis
What does the murmur sound like for ms? Diastolic rumble with and opening snap
Diastolic doming of the anterior mv leaflet. Referred to as a "hockey stick appearance" in the field
What view is best for doing planimetry to determine mv area? PSAX
Why would the left atrium become enlarged in ms? The LA pressure increases and empties slower
Why does the RV and RA enlarge with ms? When does this occur? Back up of volume and pressure. Happens after longstanding ms
What other condition will occur with long standing ms and indicates that it is severe? Pulmonary HTN
In regards to pulmonary HTN, what happens to the PA? Dilate due to increased pressure
In regards to pulmonary HTN, what happens the the IVC and Hepatic veins? Dilate with IVC failing to collapse 50%
RVVO
Paradoxical Septal Motion
Normal degree of ms by Pressure half time is... 30-60msec
Mild degree of ms by Pressure half time is... 90-150msec
Moderate degree of ms by Pressure half time is... 150-219msec
Severe degree of ms by Pressure half time is... >or=to 220msec
What is the formula to calculate MV area? 220/P 1/2t
Severe(Mean gradient of 18mmHg)
Mild mean gradient value? < 5mmHg
Moderate mean gradient value? 5-12 mmHg
Severe mean gradient value? > 12 mmHg
Normal degree of ms by the MV area method? 2.5-4cm²
Mild degree of ms by the MV area method? 1.5-2.5cm²
Moderate degree of ms by the MV area method? 1-1.5 cm²
Severe degree of ms by the MV area method? < 1 cm²
Backward flow of blood into the left atrium during systole? Mitral regurg
Causes of MR? Any abnormality of the MV apparatus
Causes of MR (Leaflet related) Prolapse, Endocarditis, Flail, Stenosis, Myxomatus degeneration
Causes of MR (Chordae related) Elongation, Ruptured
Causes of MR (Pap muscle related) Fibrosis, calcification, ischemia, rupture
Causes of MR (other causes) Prosthetic valve dysfuntion, congenital anomalies, vegetations
What is the earliest symptom of MR? Fatigue
Other S&S of MR? Dyspnea upon exertion, Orthopnea, Palpatations, Murmur
Describe the murmur associated with MR Harsh holosystolic that radiates to the axilla
Common 2d findings in MR (7) LAE, LVE, RVE, Hyperkinetic LV wall motion, LV dilatation, PHTN
What 2d finding might be found in M-Mode? AoV notching(partial mid-systolic closure due to sudden decrease in volume leaving the LV)
What does PISA measure? The effective regurgitant orifice area
How is Vena Contracta defined? The narrowest region of a jet that occurs just below the orifice of a regurgitant valve
What is the PISA formula? RV= A MR EOA x VTI MR CW
Grade 1 RV=? < 30 ml
Grade 2 RV=? 30-44 ml
Grade 3 RV=? 45-59 ml
Grade 4 RV=? >or=to 60 ml
Left Ventricular systolic performance, or ventricular contractility assessment
In the DP/DT formula, what is being measured? The increase in pressure divided by the time interval necessary for that increase to occur
How is the DP number obtained?
Normal dp/dt values? >1200 mmHg/sec
Borderline dp/dt values? 1000-1200 mmHg/sec
Abnormal dp/dt values? < 1000 mmHg/sec
A.S.E. guidelines for severity of MR Grade 1(mild) =? MR jet extends just beyond the leaflet
A.S.E. guidelines for severity of MR Grade 2(moderate) =? MR jet extends 1/3 way into LA
A.S.E. guidelines for severity of MR Grade 3(moderate/severe) =? MR jet extends 1/2 way into LA
A.S.E. guidelines for severity of MR Grade 4(severe) =? MR jet extends mid to back wall of LA
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