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Mitral Valve Disease (Epidemiology (Cause (Rheumatic (Other (Aortic,…
Mitral Valve Disease
Epidemiology
Cause
Calcific
Congenital
Rheumatic
Other
Aortic
Tricuspid
Commonest valve involvement: Mitral
Increasing prevalence
Better diagnostic tools
Increase in age
Valve related mortality - Aortic > Mitral
Sudden death ec arrhythmia
LV dysfunction
Approach
Medical treatment
Prophylaxis to endocarditis
Optimizing hemodynamic
Protecting against ventricular dysfunction
Surgical treatment
Main conventional treatment - Severe valve disease
in maintained ventricular function
Normal function and anatomy
Components
Leaflets
Anterior - continuation of aortic root wall
Chordae
Annulus
D Shaped
Fibrous ring
Located posteriorly
Normal diameter 3 cm, circumference 8-9 cm
Not a rigid structure
Normal movement toward apex in systole
Contraction
Posterior myocardial muscle
Shorten diameter by 25%
Affected by
Left atrial cavity
Dysproportions
Shape change
Enlargement
Causing
Mitral annular dilatation
Valve
Dysfunction
Incompetence
Atrial fibrillation
Papillary muscle
Function
Closing - Competence of valve
Passively
Pressure difference in systole
Atrium
Ventricle
Actively
Annular contraction
Papillary muscle contraction
Opening