Mitral regurgitation

Mitral regurgitation

1. symptoms

   • progressive exertional dyspnoea
   • palpitations
   • fatigue
   • severe
     • pulmonary oedema

2. signs

   • pulse
     • jerky
     • ?AF
   • chest
     • fine bibasal crackles
       • PO due to LV overload
     • parasternal heave
       • left atrial enlargement
     • loud P2
       • pulmonary HTN
     • Pansystolic murmur
       • at apex
       • radiates to axilla
       • loudest on expiration
     • systolic apical thrill
     • apex beat
       • displaced
       • thrusting

3. causes

   • rheumatic fever
   • prolapsing leaflets
   • papillary muscle dysfuction
   • rupture after inferior MI
   • cardiomyopathy
   • Ventricular dilatation/ dysfunction

4. pathophysiology

   • chronic
     • volume overload
       • atrial dilatation
       • ventricular dilatation

5. management

   • pulmonary congestion
     • diurectics
   • acute regurgitation
     • vasodilators
   • AF
     • digoxin
     • anticoagulants
   • mitral valve replacement

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