心脏瓣膜病（Valvular heart disease）.docVIP

心脏瓣膜病（Valvular heart disease） One, rheumatic heart valve disease Narrow - 1. Generation of noise - turbulence - - direction inconsistent - return flow (1) two steps: the valve position, the valve switch Mitral stenosis: apical diastolic murmurs Mitral valve closure: systolic murmurs in the apex Aortic valve closure: the diastolic murmur of the second costal margin of the right margin of the sternum Aortic stenosis: systolic murmurs in the second intercostal margin of the sternal right margin Pulmonary artery 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 (5th rib) Pulmonary valve: the left margin of the sternum Aortic valve: the right margin of the sternum; Left margin of sternum (second listening area) Tricuspid valve: the left margin of the sternum is 4 and 5 Learning methods: memorize the relative position of the heart valve Mitral stenosis (1) normal mitral valve area is about 4 ~ 6cm2 Hemodynamic disorders were found in the flap area 1.5 cm2. Mild stenosis of 1.5 ~ 2.0 cm2 Moderate stenosis, flap area 1.0 ~ 1.5 cm2 Severe stenosis and the area of the flap 1.0 cm2 (2) etiology 1) rheumatic fever (- [most common], 25%), 2/3 is [female]. 2) repeated streptococcus tonsillitis or angina, with no history of rheumatic fever. 3) other causes are rare: such as congenital deformity, aging calcium, wind guan, SLE, etc. (3) two major features of mitral stenosis: the left atrium is large (not large left); In a large (4) symptoms: 1) when the mitral valve is moderately narrow and 1.0 cm2 is 1.5 cm2, the severe hemodynamic changes can lead to obvious symptoms. 2) [breathing difficulties] is the most common symptom; [haemoptysis] can be manifested in different forms, large hemoptysis, phlegm with blood or pink frothy phlegm. 3) difficulty breathing -- hemoptysis -- right heart failure (edema); Increase of left atrial; The right ventricular enlargement; (5) physical cha