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) is the narrowing of the mitral valve Mitral valve The valve between the left atrium and left ventricle of the heart. Heart: Anatomy (MV) orifice, leading to obstructed blood 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 the left atrium (LA) to the left ventricle (LV). Mitral stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) is most commonly due to rheumatic heart disease Rheumatic Heart Disease Cardiac manifestation of systemic rheumatological conditions, such as rheumatic fever. Rheumatic heart disease can involve any part the heart, most often the heart valves and the endocardium. Rheumatic Fever. Mitral stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) leads to impaired LV diastolic filling, increased LA pressure, and LA dilation, which can result in atrial fibrillation Atrial fibrillation Atrial fibrillation (AF or Afib) is a supraventricular tachyarrhythmia and the most common kind of arrhythmia. It is caused by rapid, uncontrolled atrial contractions and uncoordinated ventricular responses. Atrial Fibrillation, pulmonary congestion, pulmonary hypertension Hypertension Hypertension, or high blood pressure, is a common disease that manifests as elevated systemic arterial pressures. Hypertension is most often asymptomatic and is found incidentally as part of a routine physical examination or during triage for an unrelated medical encounter. Hypertension, and right 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). Symptoms include exertional 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, palpitations Palpitations Ebstein’s Anomaly, 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, and hoarseness Hoarseness An unnaturally deep or rough quality of voice. Parapharyngeal Abscess. Physical examination will demonstrate an opening snap, followed by a rumbling diastolic murmur. An echocardiogram Echocardiogram Transposition of the Great Vessels is used for diagnosis. Treatment includes sodium Sodium A member of the alkali group of metals. It has the atomic symbol na, atomic number 11, and atomic weight 23. Hyponatremia restriction, diuretics Diuretics Agents that promote the excretion of urine through their effects on kidney function. Heart Failure and Angina Medication, atrial fibrillation Atrial fibrillation Atrial fibrillation (AF or Afib) is a supraventricular tachyarrhythmia and the most common kind of arrhythmia. It is caused by rapid, uncontrolled atrial contractions and uncoordinated ventricular responses. Atrial Fibrillation management, possible anticoagulation Anticoagulation Pulmonary Hypertension Drugs, and percutaneous commissurotomy or surgery.
Last updated: 25 Apr, 2022
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) is the narrowing of the mitral valve Mitral valve The valve between the left atrium and left ventricle of the heart. Heart: Anatomy (MV) orifice, which impedes blood 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 the left atrium (LA) into the left ventricle (LV) during diastole Diastole Post-systolic relaxation of the heart, especially the heart ventricles. Cardiac Cycle.
Obstruction of blood 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 the LA to the LV during diastole Diastole Post-systolic relaxation of the heart, especially the heart ventricles. Cardiac Cycle due to a stenotic MV
Image by Lecturio.Normal pressure-volume loop (red line) compared to that of 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 (blue line): Mitral stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) impairs LV filling, so there is a decrease in end-diastolic volume End-diastolic volume Cardiac Cycle. This leads to an overall decrease in cardiac output Cardiac output The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). Cardiac Mechanics and 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. The circle represents the opening of the MV, and LV filling pressures that may be slightly decreased in the setting of a stenotic valve.
Image by Lecturio.A gross pathology specimen of a stenotic MV: Notice the thickened valve leaflets and narrow valve opening.
Image: “Mitral stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS), gross pathology” by CDC/Dr. Edwin P. Ewing, Jr. License: Public domain.Diastolic filling and rumbling murmur of mild and severe mitral
stenosis
Stenosis
Hypoplastic Left Heart Syndrome (HLHS)
The mid-diastolic murmur starts after the opening snap (O.S.). The presystolic murmur is due to atrial contraction (and absent in
atrial fibrillation
Atrial fibrillation
Atrial fibrillation (AF or Afib) is a supraventricular tachyarrhythmia and the most common kind of arrhythmia. It is caused by rapid, uncontrolled atrial contractions and uncoordinated ventricular responses.
Atrial Fibrillation).
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
Aortic regurgitation
Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders.
Aortic Regurgitation,
mitral valve
Mitral valve
The valve between the left atrium and left ventricle of the heart.
Heart: Anatomy 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
Aortic stenosis
Aortic stenosis (AS), or the narrowing of the aortic valve aperture, is the most common valvular heart disease. Aortic stenosis gradually progresses to heart failure, producing exertional dyspnea, angina, and/or syncope. A crescendo-decrescendo systolic murmur is audible in the right upper sternal border.
Aortic Stenosis (AS),
tricuspid regurgitation
Tricuspid regurgitation
Tricuspid regurgitation (TR) is a valvular defect that allows backflow of blood from the right ventricle to the right atrium during systole. Tricuspid regurgitation can develop through a number of cardiac conditions that cause dilation of the right ventricle and tricuspid annulus. A blowing holosystolic murmur is best heard at the left lower sternal border.
Tricuspid Regurgitation, 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))
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) frames in the parasternal long
axis
Axis
The second cervical vertebra.
Vertebral Column: Anatomy (A) and apical 4-chamber (B) views from a patient with severe
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 (MVA = 0.84 cm2) and mild
regurgitation
Regurgitation
Gastroesophageal Reflux Disease (GERD), showing a giant left atrium (GLA)
MV:
mitral valve
Mitral valve
The valve between the left atrium and left ventricle of the heart.
Heart: Anatomy
LV: left ventricle
RV: right ventricle
RA: right atrium
Echocardiographic frames from a patient with
rheumatic heart disease
Rheumatic Heart Disease
Cardiac manifestation of systemic rheumatological conditions, such as rheumatic fever. Rheumatic heart disease can involve any part the heart, most often the heart valves and the endocardium.
Rheumatic Fever and severe
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 (MVA 0.51 cm2), showing an enlarged LA and echo contrast in the LA. You can see some movement of the contrast through the narrowed MV.
A: apical 4-chamber view (
diastole
Diastole
Post-systolic relaxation of the heart, especially the heart ventricles.
Cardiac Cycle)
B: parasternal long-
axis
Axis
The second cervical vertebra.
Vertebral Column: Anatomy view (
diastole
Diastole
Post-systolic relaxation of the heart, especially the heart ventricles.
Cardiac Cycle)
LA: left atrium
LV: left ventricle
RV: right ventricle
MV:
mitral valve
Mitral valve
The valve between the left atrium and left ventricle of the heart.
Heart: Anatomy
AV:
aortic valve
Aortic valve
The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle.
Heart: Anatomy
A cMRI assessing
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. Top: diastolic frame from a LV outflow tract view demonstrating the slice position for subsequent imaging (dashed line);
Bottom: resulting modified short-
axis
Axis
The second cervical vertebra.
Vertebral Column: Anatomy view through the MV in
diastole
Diastole
Post-systolic relaxation of the heart, especially the heart ventricles.
Cardiac Cycle, showing the narrowed mitral orifice (arrow)
Percutaneous mitral valvotomy in a case of situs inversus totalis and juvenile rheumatic critical 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. A: Accura balloon entering into the LV; B: distal inflation of the balloon; C: mitral valve Mitral valve The valve between the left atrium and left ventricle of the heart. Heart: Anatomy dilation
Image: “Accura balloon” by the Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India. License: CC BY 2.0.