Mitral valve prolapse & MS

Mitral valve prolapse is the most common valvular abnormalities. So, take note.

However , the most common symptom is NO SYMPTOMS AT ALL.

So lets say , you detected it in an asymptomatic patients? You jz keep him reassured.

In symptomatic patients, do your investigation( echo) , follow up and if indicated, mitral valve repair.

So listen carefully

Midsystolic click..

Can someone summarize this for me?

Mitral annulus calcification(MAC) can produce both mitral stenosis / mitral regurgitation and the latter is more common.

Causes of MAC? ageing , atherosclerosis association,
read more here

In mitral stenosis , increase in left atrial size leads to increase excitability thus, atrial fibrillation (AF)occurs.

AF causes loss of atrial kick , hence further lowering the cardiac output

Hey guys, finally a proper explanation for tapping apex!
read futher here

20120415-151525.jpg

Tapping apex is…… PALPABLE S1!!!!(mitral area) its just an exaggeration of the normal apex… I think?
Correct me

OPENING SNAP is caused by????
Forceful opening of mitral valve if stenosed.but but why the forceful opening?why doesnt this happen in other valves like aortic stenosis?
From what i have understood, first, we need to know that due to the stenotic mitral valve, this impedes the blood from flowing freely to the left ventricle, creating some sort of pressure gradient.so possibly this forceful opening is due to the high pressure gradient difference whereby the pressure in left atrium is 25 mmhg while in the left ventricle , 5 mmhg ( all of this during diastolic phase).. Normally there is NO PRESSURE GRADIENT.

And also the reason behind this is because of the anatomy of the mitral valve itself.( i dont know exactly why but if someone knows , i beg you to tell me). All i know is it is a bicuspid valve,with the anterior leaflets larger than the posterior one… But in aortic valve, its a tricuspid..and it is more rounded… So???? I dont get it.. I think i know but im not 100% sure.help?

The famous question

Signs of mitral stenosis….( i was asked this lucky question once when i wasnt prepared… By an intelligent professor… I was sort of humiliated in front of a bunch of egyptian guys and its really embarassing since i was alone at that moment, but i took it positively, it spurred me to work harder)

Malar flush
Tapping apex
Signs of pulmonary hypertension- diastolic shock; palpable 2nd heart sound in the pulmonary area, possibly; rt vt hypertrophy with its signs- heaving apex, ejection systolic click
Loud S1
Loud P2( due to phtn)
Mid diastolic rumble(Low pitched- hear it with the bell!!!!!!!!!!) or let him roll to the left to clarify your findings or exercise.
Presystolic accentuation( caused by atrial contraction and lost if atrial fibrillation present)
Jugular venour pressure elevation; due to phtn so–> prominent “a” OR loss of “a”(due to AF in the right that is… Perhaps because of the phtn????)

Systolic Ejection sounds occur shortly after the first heart sound, at the time of ventricular ejection. Normally, the opening of the aortic or pulmonic valves and the onset of ventricular ejection is not audible. In certain cardiac conditions extra sounds are heard shortly after the first heart sound, S1. They are produced by the opening of the aortic or pulmonic valves, either when one of these valves is diseased (valvular) or when ejection is rapid through a normal valve (vascular).
Aortic ejection sounds of valvular origin are heard in patients with coarctation of the aorta usually associated with congenital bicuspid aortic valve, valvular aortic stenosis, aortic insufficiency, or aneurysm of the ascending aorta. Valvular ejection sounds may be heard in clinical conditions associaated with forceful left ventricular ejection, such as thyrotoxicosis, anemia, pregnancy, exercise, high cardiac output states.
Aortic ES is loudest at aortic area and cardiac apex with no respiratory variations.

Pulmonic ejection sounds are associated with dilatation of the main pulmonary artery, including pulmonary hypertension and valvular pulmonary stenosis. Pulmonary ES is best heart at pulmonic area and decreases coincident with inspiration.

Source;here

So theres no SNAP, but theres the CLICK.
The weird thing is Regardless of the stenosis or the regurgitation, it produces the CLICK.( for semilunar valves)

ecg findings of MS
normal OR
P-mitrale- broad notched P wave due to left atrium overload definition
Signs of rt vt hypertrophy( this needs a long explanation)
AF- seen as FIBRILLATORY WAVES

I think thats enough.here. I mean. Further elaboration in books.duh!

This is percutaneous mitral ballon valvotomy

Pssst! Most common cause of MS is rheumatic heart disease!!!!

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