Diferencia entre revisiones de «Mitral regurgitation»
(mngt) |
|||
| Línea 1: | Línea 1: | ||
===Diagnosis=== | ===Diagnosis=== | ||
*Most common cause is papillary / chordae rupture after MI | *Most common cause is papillary / chordae rupture after MI<ref>Kosowsky JM: Infective Endocarditis and Valvular Heart Disease, in Marx JA, Hockberger RS, Walls RM, et al (eds): Emergency Medicine: Concepts and Clinical Practice, ed. 7. St. Louis, Mosby, Inc., 2010, (Ch) 81: p.1072-1074.</ref> | ||
**Day 2-7 | |||
*MI, Endocarditis, Trauma | |||
*Severe dyspnea, tachycardia, pulmonary edema | |||
*Suspect if new-onset pulm edema + normal heart size | *Suspect if new-onset pulm edema + normal heart size | ||
*Cardiogenic shock may develop | *Cardiogenic shock may develop | ||
*S4, apical systolic murmur | *S4, apical systolic murmur | ||
| Línea 12: | Línea 14: | ||
**Decrease afterload | **Decrease afterload | ||
**Consider nitroprusside in normotensive pts | **Consider nitroprusside in normotensive pts | ||
**Dobutamine | |||
*Consult Cards/CT Surg | |||
*Intra-aortic balloon pump, emergency surgery | |||
==See Also== | ==See Also== | ||
| Línea 18: | Línea 23: | ||
==Source== | ==Source== | ||
Tintinalli | *Tintinalli | ||
*Kosowsky JM: Infective Endocarditis and Valvular Heart Disease, in Marx JA, Hockberger RS, Walls RM, et al (eds): Emergency Medicine: Concepts and Clinical Practice, ed. 7. St. Louis, Mosby, Inc., 2010, (Ch) 81: p.1072-1074. | |||
[[Category:Cards]] | [[Category:Cards]] | ||
Revisión del 14:52 24 ene 2015
Diagnosis
- Most common cause is papillary / chordae rupture after MI[1]
- Day 2-7
- MI, Endocarditis, Trauma
- Severe dyspnea, tachycardia, pulmonary edema
- Suspect if new-onset pulm edema + normal heart size
- Cardiogenic shock may develop
- S4, apical systolic murmur
Treatment
- Decrease pulmonary edema
- O2, nitrates, diuretics
- Increase forward flow
- Decrease afterload
- Consider nitroprusside in normotensive pts
- Dobutamine
- Consult Cards/CT Surg
- Intra-aortic balloon pump, emergency surgery
See Also
Source
- Tintinalli
- Kosowsky JM: Infective Endocarditis and Valvular Heart Disease, in Marx JA, Hockberger RS, Walls RM, et al (eds): Emergency Medicine: Concepts and Clinical Practice, ed. 7. St. Louis, Mosby, Inc., 2010, (Ch) 81: p.1072-1074.
- ↑ Kosowsky JM: Infective Endocarditis and Valvular Heart Disease, in Marx JA, Hockberger RS, Walls RM, et al (eds): Emergency Medicine: Concepts and Clinical Practice, ed. 7. St. Louis, Mosby, Inc., 2010, (Ch) 81: p.1072-1074.