SIGNS OF SEVERITY IN VALVULAR HEART DISEASE

–A QUICK GUIDE

	Mitral Stenosis	Mitral Incompetance	Aortic Incompetance	Aortic Stenosis
Pulse	Small pulse pressure	Small volume pulse	Collapsing pulse, Wide pulse pressure	Plateau pulse
Apex	Tapping, not a sign of severity per se	Enlarged left ventricle, deviated apex	Will be enlarged, not a sign of severity per se	Sustained impulse, not a sign of severity per se
Heart Sounds	Loud first heart sound, not a sign of severity per se	Soft 1^st heart sound, A2 is earlier	Soft A2	Paroxsymal splitting of A2
Added Heart sounds	Early opening Snap	Third heart sound	Third heart sound	4^th heart sound
Murmur	Length of mid-diastolic murmur	Early diastolic rumble	Length of decrescendo diastolic murmur	Length and lateness of systolic murmur
Thrill	Diastolic Thrill		Austin-Flint murmur	Aortic thrill
Ultimately,	Signs of Pulmonary Hypertension- prominent a wave, RV impulse, loud P2, Pulmonary Incompetance, Tricuspid Incompetance	Pulmonary Hypertension
		Left Ventricular failure	Left Ventricular Failure	Left Ventricular Failure