Page 117 - Clinical Pearls in Cardiology

Valvular Heart Diseases 105

Contd...
Cardiomegaly Cardiomegaly No cardiomegaly No
present present in MVP cardiomegaly
Cardiomegaly
may occur in
papillary muscle
dysfunction
Soft, widely Narrowly split Normal S2 Soft, widely
split S2 S2 split S2
S4 usually
present

Loud, Soft, early Soft, mid to late Loud and
holosystolic systolic systolic cre- harsh early
murmur murmur scendo murmur systolic decre-
with mid or with definite extending or scendo type
late systolic late systolic fanning to S2 of murmur
crescendo decrescendo (accentuation) (attenuation)
(accentuation) (attenuation)
9. What are the common causes of mitral stenosis?
Mitral stenosis is the reduction in the cross-sectional
area of the mitral valve. The cross-sectional area of the
normal mitral valve is 4 to 6 sq cm. The important causes
of mitral stenosis are the following:
• Inflammatory—in rheumatic fever (the average latent
period from acute rheumatic fever attack to the onset
of cardiac symptoms due to mitral stenosis is 19 years
and about 50% of patients with mitral stenosis do not
give past history of rheumatic fever).
• Congenital mitral stenosis.
• Endomyocardial fibrosis.