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Signs of Mitral stenosis(5)
Tapping apex beat (due to a loud 1st heart sound)

Malar flush

AF

Mid diastolic murmur

Raised JVP (late sign)

No change in location of apex beat!
Why is the 1st heart sound so loud?
The pressure in the right atria is high with mitral stenosis (to force blood thorugh a narrowed vessel). In a normal heart the mitral valve glides shut, however when stenosed it stays open longer until the end of diastole and when systole occurs is slammed shut.
Rx MS (3)
Medical: Digoxin, beta blockers + calcium antagonists (control ventricular rate in AF) diuretics

Valvuloplasty

Valve replacement