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.
4. 2nd Day of admission
Sudden onset Breathlessness
ī´Vitals Pulse 90bpm Temp afebrile
BP 150/90mmHg R/R 25pm
ī´CVS S1soft,S2 normal.pansystolic apical
murmur
ī´Resp Vesicular breathing with bilateral
basal crepetations.
ī´Rest of the systems intact.
5.
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.
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19. Blood supply of Papillary muscles
ī´Posteromedial
right coronary artery/left circumflex
ī´Anterolateral
LAD + Diagonal branch of LAD
21. Epidemiology:
ī´50% of MI is associated with at least
mild MR.
ī´10% of MI is associated with moderate
ischemic MR.
ī´Ischemic MR is associated with reduced
event-free survival.
22. Signs on Auscultation
ī´S1 Diminished
ī´S2 wide splitting(early closure of AV)
ī´S3 (Increased Blood flow through MV)
ī´Pansystolic apical murmur
