Ischemic MR case based
- 1. Ischemic mitral regurgitation Dr Muhammad Nouman (PGR) Dr Nazia (PGR) Dr Imama (HO)
- 2. Clinical scenario M.Razi 63 years of age,diagnosed Hypertensive for last 10 years,brought to ECCU having following complaint: Chest pain 2hours Diagnosis of Acute Inferoposterior wall MI was made on the basis of Hx + ECG findings Inj streptokinase given.
- 3. 0:11RUPTURE PAPILLARY MULSCLE SEVRE MR AMIYouTube app - 6 years ago
- 4. 2nd Day of admission Sudden onset Breathlessness Vitals Pulse 90bpm Temp afebrile BP 150/90mmHg R/R 25pm CVS S1soft,S2 normal.pansystolic apical murmur Resp Vesicular breathing with bilateral basal crepetations. Rest of the systems intact.
- 6. Ischemic MR Definition Ischemic MR is defined as MR occurring after myocardial infarction with one or more segmental wall motion abnormalities, significant coronary disease in one of the territories supplying the wall motion abnormalities, and structurally normal mitral valve leaflets and chordae tendinae.
- 19. Blood supply of Papillary muscles Posteromedial right coronary artery/left circumflex Anterolateral LAD + Diagonal branch of LAD
- 21. Epidemiology: 50% of MI is associated with at least mild MR. 10% of MI is associated with moderate ischemic MR. Ischemic MR is associated with reduced event-free survival.
- 22. Signs on Auscultation S1 Diminished S2 wide splitting(early closure of AV) S3 (Increased Blood flow through MV) Pansystolic apical murmur
- 27. Management Medical Manage MI Inotropic support Diurtics Nitrates ACEis B blockers/ccb Surgical CABG+MVR in moderate to severe MR Replacement in acute severe symptomatic & ch.severe symptomatic+non symptomatic