Patient (condition)
 
Aliases:
Mitral valve prolapse (MVP)
MVR
MR
MV regurge
Mitral Valve Prolapse
MV Prolapse
MVP
Mitral regurgitation
Mitral regurge

Topic aliases are alternate phrasings for a particular topic.


Severity based on valve area (cm2):
Critical/Severe <1.0;
Moderate 1-1.5;
Symptomatic 1.5- 2.5;
Normal 4-6

#ref

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Symptoms include dyspnoea, fatigue, haemoptysis and palpitations

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Clinical signs:
Low volume pulse;
diastolic murmur in axilla heard best in the left lateral position;
signs of LVF (creps, hypoxia);
signs of pulmonary hypertension (loud P2, RV heave);
signs of RHF (pedal oedema, elevated JVP)

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If patient awaiting valve repair develops relapsing sepsis (eg cholelithiasis/ biliary sepsis), it may be better to accept higher risk to fix ( cholecystectomy), than risk sepsis after valve repair

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If severe symptomatic disease is present ensure any incidental surgery is booked to be done in-hours by consultant anaesthetist and consultant surgeon.

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Maintain high normal heart rate to minimise regurgitant time

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Maintain low afterload. Minimising left ventricular systolic pressure through afterload reduction decreases the pressure gradient from the left ventricle to the left atrium during systole. This results in a decrease in regurtitant volume. Yao & Artusio

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