17 - Valvular Heart Disease 1

Question 1

5 determinants of blood flow through valves

Answer 1

pressure gradient
orifice geometry
time of flow through valve
fluid rheology
chamber stiffness

Question 2

regurg and stenosis lead to what overload conditions, respectively?

Answer 2

regurg - volume overload

stenosis - pressure overload

Question 3

consequences of valvular heart disease

Answer 3

hypertrophy
CHF
arrhythmias like VT/Vfib or A fib
endocarditis
embolism

Question 4

which two valves are most commonly affected by valvular dz?

Answer 4

aortic and mitral

Question 5

2 MCC of aortic stenosis

Answer 5

bicuspid valve, senile calcific degeneration

Question 6

aortic stenosis first leads to systolic/diastolic dysfunction

Answer 6

diastolic

Question 7

AS murmur

Answer 7

systolic
crescendo-decrescendo
heard at base
radiates to neck

Question 8

classic clinical triad of AS

Answer 8

angina
syncope
dyspnea / CHF

Question 9

tx for AS

Answer 9

valve replacement

Question 10

causes of aortic insufficiency

Answer 10

acute - aortic dissection, trauma, infection (valve cusps)

chronic - Marfan’s, syphilis, annulo arotic ectasia, bicuspid valve, rheumatic dz, prolapse, degenerative

Question 11

is the aortic regurg murmur shorter in acute or chronic?

Answer 11

acute

Question 12

cutoff for severe aortic insufficiency

Answer 12

over 50% regurg percentage

Question 13

pathophys of chronic aortic insufficiency

Answer 13

progressive leak > LV eccentric hypertrophy > wide pulse pressure > gradual decline of systolic function

Question 14

tx of aortic insufficiency

Answer 14

for mild, may be able to get a way w/ just vasodilators

severe - need to replace valve or repair underlying aorta problem