mitral stenosis

[trgf]

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When mitral stenosis becomes severe enough to precipitate atrial fibrillation, presystolic accentuation of the MS murmur disappears. How does this happen? Wouldn't it more sense to hear a continuous rumble?

 

[greatnt249]

When mitral stenosis becomes severe enough to precipitate atrial fibrillation, presystolic accentuation of the MS murmur disappears. How does this happen? Wouldn't it more sense to hear a continuous rumble?

My reasoning? If the atria are fibrillating, they aren't generating high enough pressures in the chambers to force much blood through the stenotic valve. Since the turbulent flow of blood is what produces the murmur, perhaps not enough blood is forced through the valve with each atrial "contraction" to generate an audible murmur?

Someone can correct me if my reasoning is wrong, but what's with all the cardiac questions coming out of left field?

 

[trgf]

just clearing up all the issues and questions I had while doing world qbank - otherwise what's the point of asking questions here right - memorise the stuff directly from the book. But that's not the way the exam is structured for.. another whole new topic worthy of discussion on its own.

 

[RySerr21]

My reasoning? If the atria are fibrillating, they aren't generating high enough pressures in the chambers to force much blood through the stenotic valve. Since the turbulent flow of blood is what produces the murmur, perhaps not enough blood is forced through the valve with each atrial "contraction" to generate an audible murmur?

Someone can correct me if my reasoning is wrong, but what's with all the cardiac questions coming out of left field?

yea i think you're right... the snap that you here with mitral stenosis is when the atria contract and that extre force blows open the mitral valve. If you have a fib, you don't have that inrease in pressure that forces the stenotic valve open.

 

[greatnt249]

just clearing up all the issues and questions I had while doing world qbank - otherwise what's the point of asking questions here right - memorise the stuff directly from the book. But that's not the way the exam is structured for.. another whole new topic worthy of discussion on its own.

Ah, just seems like some crazy questions that qbank is throwing at you.