Mitral regurgitation Regurgitation Gastroesophageal Reflux Disease (GERD) ( MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status) is the backflow of blood from the left ventricle (LV) to the left atrium (LA) during systole Systole Period of contraction of the heart, especially of the heart ventricles. Cardiac Cycle. Mitral regurgitation Regurgitation Gastroesophageal Reflux Disease (GERD) may be acute ( myocardial infarction Myocardial infarction MI is ischemia and death of an area of myocardial tissue due to insufficient blood flow and oxygenation, usually from thrombus formation on a ruptured atherosclerotic plaque in the epicardial arteries. Clinical presentation is most commonly with chest pain, but women and patients with diabetes may have atypical symptoms. Myocardial Infarction) or chronic (myxomatous degeneration). Acute and decompensated chronic MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status can lead to pulmonary venous congestion, resulting in symptoms of dyspnea Dyspnea Dyspnea is the subjective sensation of breathing discomfort. Dyspnea is a normal manifestation of heavy physical or psychological exertion, but also may be caused by underlying conditions (both pulmonary and extrapulmonary). Dyspnea, orthopnea Orthopnea Pulmonary Edema, and fatigue Fatigue The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. Fibromyalgia. Acute MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status is an emergency because it can cause cardiogenic shock Cardiogenic shock Shock resulting from diminution of cardiac output in heart disease. Types of Shock, and requires medical stabilization and surgery. In chronic severe MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status, patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship are evaluated for surgical repair or replacement.
Last updated: 29 Sep, 2021
Mitral regurgitation Regurgitation Gastroesophageal Reflux Disease (GERD) ( MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status) is the backflow of blood to the left atrium (LA) through the mitral valve Mitral valve The valve between the left atrium and left ventricle of the heart. Heart: Anatomy (MV) during ventricular contraction.
Reflux of blood into the LA during systole Systole Period of contraction of the heart, especially of the heart ventricles. Cardiac Cycle with MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status
Image by Lecturio.Relationship Relationship A connection, association, or involvement between 2 or more parties. Clinician–Patient Relationship between LV pressure (green line), normal LA pressure (dashed red line), and LA pressure in MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status (solid red line) throughout the cardiac Cardiac Total Anomalous Pulmonary Venous Return (TAPVR) cycle Cycle The type of signal that ends the inspiratory phase delivered by the ventilator Invasive Mechanical Ventilation: In MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status, LV contraction ejects blood into the LA, leading to a systolic murmur and elevation of the LA pressure (increased v wave V wave Cardiac Cycle).
Image by Lecturio.Left ventricle (LV) wall stress-volume loop in acute mitral regurgitation Regurgitation Gastroesophageal Reflux Disease (GERD) ( MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status): Early adaptation to acute MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status comprises an increase in end-diastolic volume End-diastolic volume Cardiac Cycle, a characteristic systolic unloading, and a decrease in end-systolic volume End-systolic volume Cardiac Cycle. As a result, the total stroke volume Stroke volume The amount of blood pumped out of the heart per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume. Cardiac Cycle increases.
Image by Lecturio.Left ventricle (LV) wall stress-volume loops in the 3 stages of chronic mitral regurgitation Regurgitation Gastroesophageal Reflux Disease (GERD) ( MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status): As the ventricle adapts to the chronic hemodynamic burden, a progressive increase in LV end-diastolic volume End-diastolic volume Cardiac Cycle and systolic wall stress occurs. The ejection fraction Ejection fraction Cardiac Cycle progressively lowers from 65% in compensated MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status, to 55% during the transitional stage, and finally to ≤ 45% in decompensated MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status.
Image by Lecturio.Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship will often present with signs and symptoms of acute heart failure Heart Failure A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (ventricular dysfunction), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as myocardial infarction. Total Anomalous Pulmonary Venous Return (TAPVR) or cardiogenic shock Cardiogenic shock Shock resulting from diminution of cardiac output in heart disease. Types of Shock:
Audio:
This audio clip is an example of an acute mitral regurgitation Regurgitation Gastroesophageal Reflux Disease (GERD) murmur. An early systolic murmur is heard, which decrescendos and ends before S2 S2 Heart Sounds.
Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship will often be asymptomatic for years. Symptoms tend to develop with a decrease in cardiac Cardiac Total Anomalous Pulmonary Venous Return (TAPVR) output or cardiac Cardiac Total Anomalous Pulmonary Venous Return (TAPVR) dysfunction:
Phonocardiograms of abnormal
heart sounds
Heart sounds
Heart sounds are brief, transient sounds produced by valve opening and closure and by movement of blood in the heart. They are divided into systolic and diastolic sounds. In most cases, only the first (S1) and second (S2) heart sounds are heard. These are high-frequency sounds and arise from aortic and pulmonary valve closure (S1), as well as mitral and tricuspid valve closure (S2).
Heart Sounds caused by the following
cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) defects:
aortic
regurgitation
Regurgitation
Gastroesophageal Reflux Disease (GERD),
mitral valve prolapse
Mitral valve prolapse
Abnormal protrusion or billowing of one or both of the leaflets of mitral valve into the left atrium during systole. This allows the backflow of blood into left atrium leading to mitral valve insufficiency, systolic murmurs, or cardiac arrhythmia.
Mitral Valve Prolapse, mitral
stenosis
Stenosis
Hypoplastic Left Heart Syndrome (HLHS) (
MS
MS
Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease that leads to demyelination of the nerves in the CNS. Young women are more predominantly affected by this most common demyelinating condition.
Multiple Sclerosis), aortic
stenosis
Stenosis
Hypoplastic Left Heart Syndrome (HLHS) (AS), tricuspid
regurgitation
Regurgitation
Gastroesophageal Reflux Disease (GERD), hypertrophic obstructive
cardiomyopathy
Cardiomyopathy
Cardiomyopathy refers to a group of myocardial diseases associated with structural changes of the heart muscles (myocardium) and impaired systolic and/or diastolic function in the absence of other heart disorders (coronary artery disease, hypertension, valvular disease, and congenital heart disease).
Cardiomyopathy: Overview and Types (HOCM),
atrial septal defect
Atrial Septal Defect
Atrial septal defects (ASDs) are benign acyanotic congenital heart defects characterized by an opening in the interatrial septum that causes blood to flow from the left atrium (LA) to the right atrium (RA) (left-to-right shunt).
Atrial Septal Defect (ASD) (
ASD
ASD
Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by poor social skills, restricted interests/social interactions, and repetitive/stereotyped behaviors. The condition is termed a “spectrum” because of the wide variability in the severity of symptoms exhibited.
Autism Spectrum Disorder),
ventricular septal defect
Ventricular Septal Defect
Tetralogy of Fallot (VSD), and
patent ductus arteriosus
Patent ductus arteriosus
The ductus arteriosus (DA) allows blood to bypass pulmonary circulation. After birth, the DA remains open for up to 72 hours and then constricts and involutes, becoming the ligamentum arteriosum. Failure of this process to occur results in patent ductus arteriosus (PDA), a condition that causes up to 10% of congenital heart defects.
Patent Ductus Arteriosus (PDA) (
PDA
PDA
The ductus arteriosus (DA) allows blood to bypass pulmonary circulation. After birth, the DA remains open for up to 72 hours and then constricts and involutes, becoming the ligamentum arteriosum. Failure of this process to occur results in patent ductus arteriosus (PDA), a condition that causes up to 10% of congenital heart defects.
Patent Ductus Arteriosus (PDA))
Audio:
This audio clip is an example of a holosystolic murmur Holosystolic Murmur Tricuspid Valve Atresia (TVA) from mitral regurgitation Regurgitation Gastroesophageal Reflux Disease (GERD). The murmur gives a high-pitched, “blowing” sound through the entirety of systole Systole Period of contraction of the heart, especially of the heart ventricles. Cardiac Cycle.
Audio:
This audio clip is an example of an S3 gallop S3 gallop Congestive Heart Failure in addition to a holosystolic mitral regurgitation Regurgitation Gastroesophageal Reflux Disease (GERD) murmur. This extra heart sound after S2 S2 Heart Sounds can result due to increased flow Flow Blood flows through the heart, arteries, capillaries, and veins in a closed, continuous circuit. Flow is the movement of volume per unit of time. Flow is affected by the pressure gradient and the resistance fluid encounters between 2 points. Vascular resistance is the opposition to flow, which is caused primarily by blood friction against vessel walls. Vascular Resistance, Flow, and Mean Arterial Pressure or dilation of the left ventricle.
Display of end-systolic image from apical 4-chamber view: The white, thicker, arrow indicates moderate MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status.
Image: “F2” by the Department of Clinical Sciences, Division of Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus & Endocrinology, Lund University, Malmö University Hospital, Malmö, Sweden. License: CC BY 2.0.Two-dimensional (2D)
echocardiogram
Echocardiogram
Transposition of the Great Vessels with apical 4-chamber view and color
Doppler
Doppler
Ultrasonography applying the doppler effect, with frequency-shifted ultrasound reflections produced by moving targets (usually red blood cells) in the bloodstream along the ultrasound axis in direct proportion to the velocity of movement of the targets, to determine both direction and velocity of blood flow.
Ultrasound (Sonography). A: Pre-operative: Moderate-to-severe
MR
MR
Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population.
Measures of Health Status is present.
B: Postoperative: Trivial
MR
MR
Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population.
Measures of Health Status is seen in the LA.
Transthoracic echocardiography Echocardiography Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. Tricuspid Valve Atresia (TVA). A: parasternal long- axis Axis The second cervical vertebra. Vertebral Column: Anatomy modified view; B: normal parasternal long- axis Axis The second cervical vertebra. Vertebral Column: Anatomy view with color Doppler Doppler Ultrasonography applying the doppler effect, with frequency-shifted ultrasound reflections produced by moving targets (usually red blood cells) in the bloodstream along the ultrasound axis in direct proportion to the velocity of movement of the targets, to determine both direction and velocity of blood flow. Ultrasound (Sonography) flow Flow Blood flows through the heart, arteries, capillaries, and veins in a closed, continuous circuit. Flow is the movement of volume per unit of time. Flow is affected by the pressure gradient and the resistance fluid encounters between 2 points. Vascular resistance is the opposition to flow, which is caused primarily by blood friction against vessel walls. Vascular Resistance, Flow, and Mean Arterial Pressure from an adult patient with moderate MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status and shortened chordae tendineae Chordae tendineae The tendinous cords that connect each cusp of the two atrioventricular heart valves to appropriate papillary muscles in the heart ventricles, preventing the valves from reversing themselves when the ventricles contract. Heart: Anatomy; C: 2D TEE TEE Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues using a transducer placed in the esophagus. Imaging of the Heart and Great Vessels and D: color flow Flow Blood flows through the heart, arteries, capillaries, and veins in a closed, continuous circuit. Flow is the movement of volume per unit of time. Flow is affected by the pressure gradient and the resistance fluid encounters between 2 points. Vascular resistance is the opposition to flow, which is caused primarily by blood friction against vessel walls. Vascular Resistance, Flow, and Mean Arterial Pressure Doppler Doppler Ultrasonography applying the doppler effect, with frequency-shifted ultrasound reflections produced by moving targets (usually red blood cells) in the bloodstream along the ultrasound axis in direct proportion to the velocity of movement of the targets, to determine both direction and velocity of blood flow. Ultrasound (Sonography) from another adult patient with severe MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status and shortened cordae tendineae
(Note the posterior mitral leaflet with limited mobility Mobility Examination of the Breast (arrow), and the eccentric regurgitant jet oriented to the posterior atrial wall.)
Image: “Transthoracic echocardiography Echocardiography Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. Tricuspid Valve Atresia (TVA)” by Prof. C.C. Iliescu Emergency Institute of Cardiovascular Diseases, 258 Fundeni Street, District 2, Bucharest, Romania. License: CC BY 2.0.Acute MR MR Calculated as the ratio of the total number of people who die due to all causes over a specific time period to the total number of people in the selected population. Measures of Health Status is a medical emergency that requires medical stabilization and supportive care until surgery can be performed: