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| | ==Differential Diagnosis== |
| | {{Valvular emergencies DDX}} |
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| ==Mitral Regurgitation== | | ==See Also== |
| ===Diagnosis===
| | *[[Heart Murmurs]] |
| *Most common cause is papillary / chordae rupture after MI
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| *Suspect if new-onset pulm edema + normal heart size
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| *Severe dyspnea, tachycardia, pulmonary edema
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| *Cardiogenic shock may develop
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| *S4, apical systolic murmur | |
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| ===Treatment=== | | ==References== |
| *Decrease pulmonary edema
| | <references/> |
| **O2, nitrates, diuretics
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| *Increase forward flow
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| **Decrease afterload
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| **Consider nitroprusside in normotensive pts
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| ==Aortic Stenosis==
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| ===Diagnosis===
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| *Dyspnea, CP, syncope
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| **Once symptoms present mean surival is 2-3yr
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| *Late systolic murmur radiating to carotids
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| *Pulsus parvus et tardus
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| *Narrowed pulse pressure
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| ===Treatment===
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| *Admission
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| *Avoid BBs, CCBs
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| *Afterload reduction is controversial
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| **Consider cards consult
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| *AS + A-fib = emergency
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| **Consider emergent cardioversion
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| *Pulm edema
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| **Diuretics, intubation if necessary
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| **Extreme caution with use of nitrates/vasodilators
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| ==Aortic Regurgitation==
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| *Causes
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| **Endocarditis
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| **Aortic dissection
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| **Blunt chest trauma
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| ===Diagnosis===
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| *Pulmonary edema
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| *Wide pulse pressure
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| *Dyspnea
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| *Hypotension (may progress to cardiogenic shock)
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| *Diastolic murmur heard immediately after S2
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| *CXR
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| **Pulmonary edema w/o cardiac enlargement
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| ===Treatment===
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| *Immediate surgical intervention
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| *Reduce afterload
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| **Nitroprusside
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| *Diuretics and nitrates don't work
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| *Don't use beta blockers (block compensatory tachycardia)
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| ==See Also==
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| [[Heart Murmurs]]
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| ==Source==
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| Tintinalli
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| [[Category:Cards]] | | [[Category:Cardiology]] |
