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CVD > 15. Valve Disease > Flashcards

15. Valve Disease Flashcards

1
Q

What are the causes of aortic stenosis?

A 
Degenerative calcification
Congenital bicuspid valve
Rheumatic fever
Radiation
Connective tissue disease
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2
Q

What are the risks for aortic stenosis?

A

End stage renal disease
High cholesterol
Atherosclerosis

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3
Q

Why is LV hypertrophy a consequence of aortic stenosis?

A

High pressure gradient means LV is at a higher pressure to maintain CO

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4
Q

What can result from aortic stenosis?

A

Heart failure
Arrhythmias
Syncope
Angina

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5
Q

What are the signs of aortic stenosis?

A 
Ejection systolic murmur at the right upper sternal border, radiating to carotids
Low volume slow rising pulse
Single S2
S4
Displaced apex beat
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6
Q

What effect does aortic regurgitation have on heart mechanics?

A

Increases end diastolic volume

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7
Q

What are the causes of aortic regurgitation?

A

Cusp disease
Aortic root dilation
Aortic dissection

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8
Q

What are the symptoms of aortic regurgitation?

A

Palpitations
Atypical chest pain
Symptoms of LV HF

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9
Q

What are the signs of aortic regurgitation?

A

‘Waterhammer’ pulse

Diastolic murmur which is relieved with Valsalva manoeuvre

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10
Q

What is the most common cause of mitral stenosis?

A

Rheumatic fever (‘fish mouth’ appearance)

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11
Q

What effect does mitral stenosis have on the heart?

A

LA dilatation, leading to atrial fib and embolus

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12
Q

What are the signs of mitral stenosis?

A

Malar flush
Increased JVP
Opening snap
Right sided heart failure

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13
Q

What are the causes of mitral regurgitation?

A 
Rheumatic
Infective endocarditis
Mitral valve prolapse
Rupture of papilllary muscle/chordae tendinae
LV dilation
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14
Q

What are the signs of mitral regurgitation?

A

Pansystolic murmur radiating to axilla

Atrial fibrillation

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15
Q

What are the common causes of tricuspid stenosis?

A

Rheumatic or carcinoid syndrome

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16
Q

What are the common causes of tricuspid regurgitation?

A

Endocarditis in an IVDU or LV failure

17
Q

What set of criteria are used to assess rheumatic fever?

A

Jones criteria

18
Q

What are the major criteria in the Jones criteria?

A 
Polyarthritis
Carditis
Sydenham's chorea
Erythema marginatum
Subcutaneous nodules
19
Q

What are the minor criteria in the Jones criteria?

A

Fever
Arthralgia
Elevated CRP or ESR
Prolonged PR

20
Q

What are the microscopic signs of rheumatic fever?

A

Aschoff bodies or Anitschokow cells at any level of the heart

21
Q

What is the difference between acute and subacute endocarditis?

A

Acute: normal valve and virulent organism
Subacute: Deformed valve and less virulent organism

22
Q

What are common pathogens in acute endocarditis?

A

Staph aureus

Enterococcus faecalis

23
Q

What is the most common pathogen in subacute endocarditis?

A

Strep viridans

24
Q

What is the most common pathogen on prosthetic valves?

A

Staph epidermidis

25
Q

What is non-infective endocarditis in debilitated patients known as?

A

Marantic endocarditis

26
Q

What non-infective endocarditis is associated with lupus?

A

Libman-Sacks disease

27
Q

What effect does a left to right shunt have on circulation?

A

Increase pulmonary blood flow causing pulmonary hypertension

28
Q

What is shunt reversal known as?

A

Eisenmenger’s syndrome

29
Q

What are the symptoms of ASD?

A

Well tolerated and usually asymptomatic

Can cause paradoxical embolisation

30
Q

What is paradoxical embolisation?

A

Thrombus crosses an intracardiac defect into systemic circulation

31
Q

What are the symptoms of a right to left shunt?

A

Hypoxaemia and cyanosis
Paradoxical embolism
Polycythaemia

32
Q

What is the sign of aortic coarctation?

A

Higher BP in upper limbs than in lower limbs

33
Q

What investigations can be done into valve disease?

A 
ECHO
TOE for mitral valve
ECG
CXR, MRI
Cardiac catheterisation
34
Q

What weeks of gestation are CV structures formed?

A

3-8 weeks

CVD (22 decks)

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