Mitral stenosis. Echo, what might you found here?
Valves are very very stenosed. Left atrium
very very enlarged. Let us manage our patient
with mitral stenosis. Remember when we talked
about that opening snap, when did we say that
the severity is worse with that opening snap?
Closer to S2. You with me? Good. So if you hear that opening
snap closer to S2, surgical intervention,
mandatory. What about that atrial fibrillation?
What are you worried about? Thrombi formation
so, therefore, what kind of drug might you
be thinking about for prophylaxis? Warfarin.
A beautiful mnemonic I worked for this is WEPT.
W warfarin, E extrinsic, PT. Now I am not a mnemonic man, you
will not find a big fat M on my chest. It's not
going to happen. But every once in a while,
strategically why not have a little fun. Treatment.
Fluid overload. And why? What happened?
Pulmonary edema. So what might you want to
use so that you can get rid of that fluid?
How about diuretic? So these are things that
you want to keep in mind when dealing with
management. What's my next step of management
when dealing with mitral stenosis specifically.