{"id":798,"date":"2014-05-19T21:16:54","date_gmt":"2014-05-19T21:16:54","guid":{"rendered":"http:\/\/drcrunch.wordpress.com\/?p=798"},"modified":"2014-05-19T21:16:54","modified_gmt":"2014-05-19T21:16:54","slug":"things-i-learnt-today-from-mrcp-part-2-revision-day-1","status":"publish","type":"post","link":"http:\/\/drcrunch.co.uk\/blog\/2014\/05\/19\/things-i-learnt-today-from-mrcp-part-2-revision-day-1\/","title":{"rendered":"Things I learnt today from MRCP Part 2 revision (Day 1)"},"content":{"rendered":"<p>From the <a href=\"\/\/www.escardio.org\/guidelines-surveys\/esc-guidelines\/guidelinesdocuments\/guidelines_valvular_heart_dis_ft.pdf\" target=\"_blank\">ESC <\/a>\u00a0and some other places:<\/p>\n<ol>\n<li>Peripartum cardiomyopathy needs heparin (prophylactic dose if ejection faction &gt; 30%, treatment dose if less than 30% or if AF or previous clot).<\/li>\n<li>Pencillin V is continued for 10 years since the last episode of rheumatic fever, or until 40, whichever is longer.<\/li>\n<li>In severe AS (valve &lt; 1cm^2, gradient &gt; 40mmHg), surgery is indicated if symptomatic or if LVEF &lt; 50% with no other cause.<\/li>\n<li>In MR, symptoms, LVEF &lt;60% or new AF are all indications for surgery, which should be valve repair ideally. Andsuper \u00a0acute MR is all about the diuretics and nitroprusside to get that afterload down.<\/li>\n<li>For MS with an area &lt;1.5, it\u2019s all about percutaneous mitral commissurotomy if there are symptoms or a high risk of thromboembolism.<\/li>\n<li>Pregnant lady needs a valve replaced? \u201cIn women who wish to become pregnant, the high risk of thromboembolic complications with a mechanical prosthesis during pregnancy\u2014whatever the anticoagulant regimen used\u2014and the low risk of elective reoperation are incentives to consider a bioprosthesis, despite the rapid occurrence of SVD in this age group.\u201d<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>From the ESC \u00a0and some other places: Peripartum cardiomyopathy needs heparin (prophylactic dose if ejection faction &gt; 30%, treatment dose if less than 30% or if AF or previous clot)&#8230;.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"spay_email":"","footnotes":"","jetpack_publicize_message":""},"categories":[2],"tags":[138,222],"class_list":["post-798","post","type-post","status-publish","format-standard","hentry","category-medical-education","tag-mrcp-part-2","tag-valve"],"jetpack_featured_media_url":"","jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p9zRNY-cS","jetpack_likes_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"http:\/\/drcrunch.co.uk\/blog\/wp-json\/wp\/v2\/posts\/798","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/drcrunch.co.uk\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/drcrunch.co.uk\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/drcrunch.co.uk\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/drcrunch.co.uk\/blog\/wp-json\/wp\/v2\/comments?post=798"}],"version-history":[{"count":0,"href":"http:\/\/drcrunch.co.uk\/blog\/wp-json\/wp\/v2\/posts\/798\/revisions"}],"wp:attachment":[{"href":"http:\/\/drcrunch.co.uk\/blog\/wp-json\/wp\/v2\/media?parent=798"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/drcrunch.co.uk\/blog\/wp-json\/wp\/v2\/categories?post=798"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/drcrunch.co.uk\/blog\/wp-json\/wp\/v2\/tags?post=798"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}