Wednesday, July 8, 2009

Severe MS & Severe TS

Severe MS & Severe TS
Lastly, I had seen a case with severe MS but mildly symptomatic and even lying flat during echocardiography. Residents raised the question of: why she is asymptomatic? Interestingly, this case has severe TS with sever MS. This is one of cases with Rheumatic TS in Egypt.
Review:
Despite the coexistence of MS, the symptoms characteristic of this valvular lesion (i.e., severe dyspnea, orthopnea, and paroxysmal nocturnal dyspnea) are usually mild or absent in the presence of severe TS because the latter prevents surges of blood into the pulmonary circulation behind the stenotic mitral valve.
Indeed, the absence of symptoms of pulmonary congestion in a patient with obvious MS should suggest the possibility of TS (Braunwald, 2008).

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