Difference between revisions of "Valvular emergencies"

Line 2: Line 2:
 
#[[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