Top Banner
MITRAL VALVE PROLAPSE
13

MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

Jan 18, 2018

Download

Documents

Mabel Jackson

4 Years PTA Irregular palpitations heart beats associated with increased sweating and SOB Patient consulted and given Verapamil for which she took for only three days and would take it intermittently for palpitation Few Hours PTA Palpitation accompanied by SOBCONSULT AND ADMISSION
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Page 1: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

MITRAL VALVE PROLAPSE

Page 2: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

CC: PALPITATION

MM, 23 y/o, F

Page 3: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.
Page 4: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

PHYSICAL EXAMINATION• Conscious, coherent, ambulatory• BP: 110/70 CR 80/min regular RR 16/min• BMI 19• Symmetrical chest expansion, narrow A-P

diameter of the chest, no retractions, clear breath sounds

• Adynamic precordium, AB at 5th LICS MCL, no murmurs, (+) midsystolic click followed by 2/6 midsystolic cresecendo murmur noted at the apex

Page 5: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

REVIEW OF SYSTEMS

• (-) dizziness• (-) loss of consciousness• (-) cough or colds• (-) PND or Orthopnea

Page 6: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

LABORATORY AND ANCILLARY TEST

• 2D Echo-Doppler: MVP, anterior mitral valve leaflet with moderate MR, slightly dilated LA with no evidence of thrombus

• 123L ECG: sinus rhythm, occasional premature atrial complexes

• CXR: Normal

Page 7: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

WHAT ARE THE COMMON PE FINDINGS OF MVP?

Question # 1

Page 8: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

Physical examination

• Body weight is often low ; asthenic• Blood pressure is usually normal or low • Orthostatic hypotension• Resting bradycardia

• Thoracic skeletal abnormalities suggesting MVP:– Scoliosis, pectus excavatum, straightened thoracic

spine, and narrowed AP dm of the chest

Zippes, D., et al. (2005) Braunwald’s Heart Disease: A textbook of Cardiovascular Medicine, 7th ed. USA: Elsevier Saunders

Page 9: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

• Auscultation:• Nonejection systolic click at least 0.14 sec after S1• Multiple mid and late systolic clicks along the L lower

sternal border• Mid to late crescendo systolic murmur that continues to A2

Zippes, D., et al. (2005) Braunwald’s Heart Disease: A textbook of Cardiovascular Medicine, 7th ed. USA: Elsevier Saunders

Page 10: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

• Dynamic Auscultation:

Zippes, D., et al. (2005) Braunwald’s Heart Disease: A textbook of Cardiovascular Medicine, 7th ed. USA: Elsevier Saunders

Page 11: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

• Dynamic Auscultation:Response of the Murmur of MVP to Interventions

Intervention Timing Intensity Standing upright

Recumbent or 0Squatting or 0Hand grip +Valsalva +Amyl nitrite +

Fuster, V.,et al. (2008) . Hurst’s The Heart, 12the ed. China: McGrawHill Co.

Page 12: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

NING =)

Yung mga hidden slides, pareho lang nung mga nakashow. Mas maganda kase yung ginawa ni

gelyn. Hehehe. Yung iba lang kase sa slides n a gnawa ko, may konting explanation

kaya sinama ko pa din. hehe

Page 13: MITRAL VALVE PROLAPSE. CC: PALPITATION MM, 23 y/o, F.

Question 2