[의대 본과 pk 실습] 부정맥의 치료 원칙 승모판막증의 병태생리 및 증상

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[의대 본과 pk 실습] 부정맥의 치료 원칙 승모판막증의 병태생리 및 증상에 대한 보고서 자료입니다.

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P may also be observed in older (>50 years) patients, often males, in whom MR is often more severe and requires surgical treatment. There is an increased familial incidence for some patients, suggesting an autosomal dominant form of inheritance.
-MVP encompasses a broad spectrum of severities, ranging from only a systolic click and murmur and mild prolapse of the posterior leaflet of the mitral valve to severe MR due to chordal rupture and massive prolapse of both leaflets. In many patients this condition progresses over years or decades. In others it worsens rapidly as a result of chordal rupture or endocarditis.
-Auscultation
The most important finding is the mid- or late (nonejection) systolic click, which occurs 0.14 s or more after the S1 and is thought to be generated by the sudden tensing of slack, elongated chordae tendineae or by the prolapsing mitral leaflet when it reaches its maximum excursion. Systolic clicks may be multiple and may be followed by a high-pitched, late systolic crescendo-decrescendo murmur, which occasionally is \"whooping\" or \"honking\" and is heard best at the apex. The click and murmur occur earlier with standing, during the strain of the Valsalva maneuver, and with any intervention that decreases LV volume, exaggerating the propensity of mitral leaflet prolapse. Conversely, squatting and isometric exercises, which increase LV volume, diminish MVP, and the click-murmur complex is delayed, moves away from S1, and may even disappear. Some patients have a mid-systolic click without the murmur; others have the murmur without a click. Still others have both sounds at different times.
* Reference
Fauci, Braunwald, Kasper, Hauser, Longo, Jameson, Loscalzo, Harrison\'s Principles of Internal Medicine, 17th ed, McGraw-Hill, 2008, Chapter 224, 230

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[의대 본과 pk 실습] 부정맥의 치료 원칙,   승모판막증의 병태생리 및 증상