Physical signs of Mitral stenosis

Physical signs of Mitral stenosis

What is the type of Apex in Mitral Stenosis

[A] Heaving apex
[B] Sustained apex
[C] Tapping apex
[D] Diffuse apex

Physical signs of Mitral stenosis

  1. Tapping apex
  2. Loud S1
  3. Opening snap
  4. Mid- diastolic murmur with presystolic accentuation
  5. P2 (pulmonic) component of the second heart sound (S2) will be loud if severe pulmonary hypertension is due to mitral stenosis.

Advanced disease may present with

  • signs of right-sided heart failure
  • parasternal heave
  • Jugular venous distension
  • hepatomegaly,
  • ascites
  • pulmonary hypertension, often presenting with a loud P2.
  • Almost all signs increase with exercise and pregnancy

Other peripheral signs include:

  • Malar flush – due to back pressure and buildup of carbon dioxide (CO2). CO2 is a natural vasodilator.
  • Atrial fibrillation – irregular pulse and loss of ‘a’ wave in jugular venous pressure
  • Left parasternal heave – presence of right ventricular hypertrophy due to pulmonary hypertension
  • Tapping apex beat that is not displaced

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