Valvular emergencies

DDx

1. Mitral Stenosis
2. Mitral Regurgitation
3. Aortic Stenosis

Aortic Regurgitation

• Causes
  • Endocarditis
  • Aortic dissection
  • Blunt chest trauma

Diagnosis

• Pulmonary edema
• Wide pulse pressure
• Dyspnea
• Hypotension (may progress to cardiogenic shock)
• Diastolic murmur heard immediately after S2
• CXR
  • Pulmonary edema w/o cardiac enlargement

Treatment

• Immediate surgical intervention
• Reduce afterload
  • Nitroprusside
• Diuretics and nitrates don't work
• Don't use beta blockers (block compensatory tachycardia)

See Also

Heart Murmurs

Source

Tintinalli