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Regurgitant fraction is the percentage of blood that regurgitates back through the aortic valve to the left ventricle due to aortic insufficiency, or through the mitral valve to the atrium due to mitral insufficiency. It is measured as the amount of blood regurgitated into a cardiac chamber divided by the stroke volume.
Mitral regurgitation, also known as mitral insufficiency or mitral incompetence, is the backward flow of blood from the left ventricle, through the mitral valve, and into the left atrium, when the left ventricle contracts, resulting in a systolic murmur radiating to the left armpit.
Velocity Time Integral is a clinical Doppler ultrasound measurement of blood flow, equivalent to the area under the velocity time curve. The product of VTI (cm/stroke) and the cross sectional area of a valve (cm2) yields a stroke volume (cm3/stroke), which can be used to calculate cardiac output.
In mitral stenosis, tapping apical impulse is present. Mid-diastolic Tricuspid stenosis: Best heard over the left sternal border with rumbling character and tricuspid opening snap with wide splitting S1. May increase in intensity with inspiration (Carvallo's sign). Tricuspid stenosis often occurs in association with mitral stenosis.
Afterload is the mean tension produced by a chamber of the heart in order to contract. It can also be considered as the ‘load’ that the heart must eject blood against. Afterload is, therefore, a consequence of aortic large vessel compliance, wave reflection, and small vessel resistance (LV afterload) or similar pulmonary artery parameters (RV afterload
Mitral valve prolapse: This is the most common cause of late systolic murmurs. It can be heard best over the apex of the heart, usually preceded by clicks. The most common cause of mitral valve prolapse is "floppy" valve (Barlow's) syndrome. If the prolapse becomes severe enough, mitral regurgitation may occur.
Afterload is a determinant of stroke volume (in addition to preload, and strength of myocardial contraction). [ 1 ] Following Laplace's law , the tension upon the muscle fibers in the heart wall is the pressure within the ventricle multiplied by the volume within the ventricle divided by the wall thickness (this ratio is the other factor in ...
Aortic regurgitation causes both volume overload (elevated preload) and pressure overload (elevated afterload) of the heart. [14] The volume overload, due to elevated pulse pressure and the systemic effects of neuroendocrine hormones causes left ventricular hypertrophy (LVH). [9] There is both concentric hypertrophy and eccentric hypertrophy in AI.