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Mitral Stenosis vs Regurgitation
Related Subjects: Chronic Heart Failure |Heart Failure and Pulmonary Oedema |Loop Diuretics |Prosthetic Metal and Tissue Valves
🫀 Mitral Stenosis vs Mitral Regurgitation
| Feature | Mitral Stenosis (MS) | Mitral Regurgitation (MR) |
|---|---|---|
| 📖 Definition | Narrowing of the mitral valve opening ➝ restricted flow from LA → LV. | Incompetence of the mitral valve ➝ blood leaks back into LA during systole. |
| ⚠️ Etiology | 💉 Rheumatic heart disease (classic cause), congenital stenosis, severe annular calcification. | 🩺 Mitral valve prolapse, rheumatic disease, infective endocarditis, ischaemic papillary muscle dysfunction. |
| 🔬 Pathophysiology | ⬆️ LA pressure → pulmonary venous congestion → pulmonary hypertension → RV strain/failure. | Volume overload of LA + LV → chamber dilation → progressive LV dysfunction → HF. |
| 😮 Symptoms | Exertional dyspnoea, fatigue, palpitations (AF), orthopnoea, hemoptysis due to pulmonary venous hypertension. | Fatigue, exertional dyspnoea, orthopnoea, palpitations, peripheral oedema, PND. |
| 🔊 Heart Sounds | Loud S1, opening snap, low-pitched diastolic rumble (apex, left lateral position). | Soft S1, high-pitched pansystolic murmur at apex → radiates to axilla. |
| ⚡ Complications | AF, pulmonary hypertension, right HF, systemic emboli (AF-related). | AF, LV failure, pulmonary hypertension, progression to decompensated HF. |
| 🩻 Diagnostic Tools |
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| 💊 Management |
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💡 Exam tip: Mitral stenosis ➝ pressure overload (big LA, pulmonary HTN, AF). Mitral regurgitation ➝ volume overload (dilated LA + LV, eccentric hypertrophy). Always listen at the apex and think about radiation: diastolic rumble (MS) vs pansystolic to axilla (MR).
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