Valvular emergencies: Difference between revisions

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#[[Mitral Stenosis]]
#[[Mitral Stenosis]]
#[[Mitral Regurgitation]]
#[[Mitral Regurgitation]]
#[[Aortic Stenosis]]


==Aortic Stenosis==
===Diagnosis===
*Dyspnea, CP, syncope
**Once symptoms present mean surival is 2-3yr
*Late systolic murmur radiating to carotids
*Pulsus parvus et tardus
*Narrowed pulse pressure
===Treatment===
*Admission
*Avoid BBs, CCBs
*Afterload reduction is controversial
**Consider cards consult
*AS + A-fib = emergency
**Consider emergent cardioversion
*Pulm edema
**Diuretics, intubation if necessary
**Extreme caution with use of nitrates/vasodilators


==Aortic Regurgitation==
==Aortic Regurgitation==

Revision as of 21:07, 18 July 2011

DDx

  1. Mitral Stenosis
  2. Mitral Regurgitation
  3. Aortic Stenosis


Aortic Regurgitation

  • Causes
    • Endocarditis
    • Aortic dissection
    • Blunt chest trauma

Diagnosis

  • Pulmonary edema
  • Wide pulse pressure
  • Dyspnea
  • Hypotension (may progress to cardiogenic shock)
  • Diastolic murmur heard immediately after S2
  • CXR
    • Pulmonary edema w/o cardiac enlargement

Treatment

  • Immediate surgical intervention
  • Reduce afterload
    • Nitroprusside
  • Diuretics and nitrates don't work
  • Don't use beta blockers (block compensatory tachycardia)

See Also

Heart Murmurs

Source

Tintinalli

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