Malar flush in valvular disease

[Kristian Cauchi Inglott]

Hi

Struggling to understand you malar flush occurs in mitral stenosis. I've read that it's due to decreased cardiac output / increased carbon dioxide levels; either way, shouldn't you also get it in aortic stenosis then?

Thanks

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[Rocher]

Hi

Struggling to understand you malar flush occurs in mitral stenosis. I've read that it's due to decreased cardiac output / increased carbon dioxide levels; either way, shouldn't you also get it in aortic stenosis then?

Thanks

I am making an educated guess here. Mitral stenosis directly leads to increased venous pressures in the pulmonary capillary bed (a reflection of high LA pressure) and thus issues with gas exchange. AS itself can lead to high venous pressures but it’s more indirect since it’s not directly downstream of the left atrium. Pulmonary edema is an end stage sign of AS whereas I would imagine it’s more common in severe MS since heart rate fluctuations also will lead to big changes in left atrial pressure.