Difference between revisions of "Valvular emergencies"

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==DDx==
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==Differential Diagnosis==
#[[Mitral Stenosis]]
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{{Valvular emergencies DDX}}
#[[Mitral Regurgitation]]
 
 
 
 
 
==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==
 
*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==
 
==See Also==
 
[[Heart Murmurs]]
 
[[Heart Murmurs]]
  
==Source==
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==References==
Tintinalli
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<references/>
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[[Category:Cards]]
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[[Category:Cardiology]]

Latest revision as of 04:52, 28 June 2016