PACES MRCP UK - Where MRCPians Meet Since 2006

MRCP is well establised as an entry exam for advanced specialist training in many countries including Malaysia. It consists of 3 paper i.e. Part1, Part2(written tests) and PACES. PACES in full means Practical Assessment of Clinical Examination Skills. It is the third part and the candidate is assessed by fellows of RCP. I passed my PACES in 2005. I am glad that many seniors had guided me throughout my preparation for PACES and I wish to share my experiences with PACES candidates via this blog.


Thursday, April 06, 2006

METALLIC Prosthetic Valve


5 types of prosthetic heart valves:


A. Starr-Edwards mitral caged ball valve.
B. Medtronic Hall tilting disk valve.
C. St. Jude bileaflet valve.


D. Hancock porcine valve.
E. Carpentier-Edwards bovine pericardial valve.

(NOT as short case)



Don't confuse yourself with the types of prosthetic valves. For PACES setting, you only need to know about:

1. Which valve is replaced?
- Mitral valve: metallic S1, loudest at mitral area
- Aortic valve: metallic S2, loudest at aortic area

2. Any complications?
- evidence of valce leakage
- IE
- Thromboembolism eg embolic stroke
- Bleeding due to overwarfarination
- Hemolytic anemia

Pitfalls
Fail to recognize bivalve replacement
Mistaken systolic flow murmur as murmur of valve dysfunction
-ONLY 2 important murmur you need to remember for valve leakage i.e. AR and MR

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