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19.9.07
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AETIOLOGY - rheumatic origin (in association with mitral and aortic valve disease; uncommon - <5%>
CLINICAL FEATURES
gradually progressive, more common in women
symptoms of associated mitral or aortic stenosis;
symptoms of right ventricular failure;
raised JVP (may be present presystolic hepatic pulsation);
mid-diastolic murmur (best heard at the lower left or right sternal edge, increased by inspiration);
CXR - enlarged RA;
ECHO - dilated RA, fused, thickened tricuspid valve, relativelly smal gradient across the tricuspid valve (5mm)-indicate the significant mitral stenosis
Category: Cardiology Notes
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