Mixed mitral valve disease

Published on 02/04/2015 by admin

Filed under Internal Medicine

Last modified 02/04/2015

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3 Mixed mitral valve disease

Instruction

Listen to this patient’s heart.

Salient features

• The patient will have signs of both mitral stenosis and regurgitation.

• The candidate will be expected to indicate the dominant lesion (see below).

Proceed as follows:

• Look carefully for surgical scars of mitral valvotomy in all patients (scars under the left breast in female patients are often missed). Patients with previous valvotomy may have regurgitation and restenosis.

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	Dominant mitral stenosis	Dominant mitral regurgitation
Apex beat	Tapping, not displaced	Heaving and displaced
First heart sound	Loud	Soft
Third heart sound	Absent

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