rheumatic hrt dz = mitral stenosis = pulmonary edema (bilateral crackles) = dyspnea

RHD. Early MR, late MS. Diastolic at the apex indicates Mitral stenosis.

Both cases result in fluid building up in the LA and pushing backwards into he lungs. Presents with pulmonary crackles and reduced compliance. Imagine all this fluid going into the lungs, and it ends up seeping out of the vessels because it can't go backwards into the Right heart, there's blood there and it can't go forward, traffic is blocked up in the Left heart too. So it goes to pulmonary tissues. Now, this means that the HYDROSTATIC pressure in the pulmonary vessels must be increased (recall: hydrostatic is push and onocotic is pull). When discussing exudate and transudate, it mentioned that anything that had to do with hydrostatic or oncotic pressures was transudate.

Point to note: this is not fluid going into the lungs due to increased capillary permeability; that's due to burns, injury, toxins and that would be exudate

Old dudette have Aortic stenosis. Atrial contraction become essential for this patient. so AS + AFIb is dangerous because this reduces the LV preload significantly and this patient develops HF. So AFib in AS patient need to correct immediately