心脏瓣膜病(国外英文资料).docVIP

心脏瓣膜病 One, rheumatic heart valve disease Narrow - 1, the production of noise -- turbulence The direction is incongruent - the return flow (1) the two-step method: a certain valve position, a two-stage valve switch Mitral stenosis: the diastolic murmur of the heart Mitral valve closure: systolic murmur of the apex Aortic flap closure: the diastolic murmur of the second costal margin of the sternum Aortic stenosis: systolic murmurs in the second costal margin of the sternum Pulmonary stenosis: systolic murmurs in the left margin of the sternum (2) step 1: fix the valve position, step 2: the valve switch Mitral valve: apex of the heart (fifth rib) Pulmonary valve: left margin of the sternum Aortic valve: the right margin of the sternum; Left margin of the sternum (second listening area) Three-pointed flap: the left margin of the sternum is 4 and 5 Learning method: remember the relative position of the heart valve Two, mitral stenosis (1) the area of normal mitral valve is approximately 4 ~ 6cm2 The area of the flap area 1.5 cm2 has hemodynamic disorders. Mild stenosis, area 1.5 ~ 2.0 cm2 Moderate stenosis, area 1.0 ~ 1.5 cm2 Severe stenosis and the area of the flap 1.0 cm2 (2) the cause 1) rheumatic fever (-most common), 25%) and two-thirds (women). 2) repeated streptococcus tonsillitis or angina, a history of rheumatic fever. 3) other causes are rare: congenital malformations, calcification of old age, wind, SLE, etc. (3) two major features of mitral stenosis: the left atrium is large (not large left); In a large (4) the symptoms: 1) when the mitral valve is moderately narrow, and 1.0 cm2 1.5 cm2, it causes severe hemodynamic changes and causes noticeable symptoms. 2) [breathing difficulty] is the most common symptom; 【 haemoptysis 】 can show in different form, big haemoptysis, phlegm with blood or pink bubble phlegm. 3) breathing difficulties -- haemoptysis -- right heart failure (edema); Left atrial enlargement. Ar; (5) signs 1) pear-shaped heart - enlarged left