1. MITRAL VALVE DISEASES

2. MITRAL VALVE DISEASES 1. Mitral valve stenosis. 2. Mitral valve regurge. 3. Mitral valve prolapse.

3. MITRAL VALVE STENOSIS Definition: Is the obstruction to diastolic flow of blood through mitral valve.

4. CAUSES Rheumatic heart disease 50% Female < Male 9 : 1 Congenital heart disease 1%

5. SYMPTOMS: 1. Dysponea 80% 2. Orthopnea 3. P.N.D.

6. 4. Hemoptysis 5. Palpitations 6. Systemic Embolism

7. 7. Systemic congestive symptoms 2nd to increased pul. Art. Pressure  Congested Neck Veins  Rt. Hypochondrial pain  Swelling of abdomen and ankel

8. SIGNS:  Molar flush area  Pulse is normal or small v.  B.P is normal  Palpable first HS (Tapping Apex)

11.  Loud first heart sound  Opening snap.  Mid-Diastolic rumbling murmur.  Presystolic accentuation.  Pulmonary signs.  Signs in presence of pulmonary hypertension.

12. E C G: Biphasic P-wave atrial activation time is increased

14. C X R: Dil. LA Dil. Pul. Art. Pul. Congestion Pul. Oedema

17. ECHO:  Thickend MVL  Decrease Mit V. opening  MV Area Less than 4 cm 2  Dilated left atrium.  2- 4 cm 2 Mild MS  1-2 cm 2 moderate MS  > cm 2 stvere MS

18. DIFF. DIAGNOSIS 1. Cary comb murmur 2. Lt. Atrial mexoma 3. Cortriatrium 4. Austen-Flint murmur

19. COMPLICATIONS: 1. AF 2. Pulmonary hypertension, RVF 3. Bronchitis 4. Pulmonary infraction 5. Syst. embolism

25. TREATMENT:   MEDICAL +++  SURGICAL+++

27. HAEMODYNAMICALLY INSIGIFICANT MITRAL INCOMPETENCE Click murmur syndrome or MVP or Barlow’s Dis.

28. SYMPTOMS:  Asymptomatic  Mild chest pain  Palpitations  Mild dyspnoea

29. Prolapse of Ant. Or Post. Mitral valve leaflet. ECHO:

30.  Normal. CXR:

31.  Non- Specific. ECG:

32. SIGNS:  Normal pluse Volume.  Normal BP.  Late systolic murmur at Apex.  Late systolic click.

33. HAEMODYNAMICALLY SIGNIFICANT MITRAL INCOMPETENCE

34. MITRAL INCOMPETENCE endocrditis Myoc. Infarction CAUSES:- 1- ACUTE

35. 2- CHRONIC:  R  Rheumatic fever 50%  Congenital heart disease ASD marfan’s MVP Coronary A-V fistula

36.   M.V. ring calcification  Myxomatous degeneration.  Traumatic heart disease

37. ACUTE LESIONS: Symptoms: * dyspnoea * palpitations

38. SIGNS: Absent 1 st HS  Pan syst. Murmur at mitral area.  syst. thrill in 50% of cases.

39. ECG: Lt V. enlargement Lt A. enlargement

40. Enlarged cardiac shadow pul. Congestion CXR:

42. Enlarged LV Enlarged LA ECHO:

43. COMPLICATIONS:   Infect. Endocarditis  Acute disruption of mitral valve  Vent. arrythmia

44. COMPLICATIONS:  Systemic embolism  Endocarditis

48. TREATMENT  Prophylactic antibiotic of complications.  Surgical MV repair  Surgical MV replacement

49. Mixed MS + MR  dyspnoea  Palpitations  Syst. Embolism  Pressure from large LA SYMPTOMS:

50. AF Rheumatic myocarditis Endocarditis Syst. Embolism COMPLICATIONS:

51. TREATMENT:   MV Repair  MV Replacement