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[OS 213] CVS Module > [3] Valvular Heart Disease in Adults > Flashcards

[3] Valvular Heart Disease in Adults Flashcards

1
Q

Define: Stenosis

A

Narrowing of heart valve

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2
Q

Define: Regurgitation

A

Failure of heart valve to close

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3
Q

Normal MV Orifice

Significant Obstruction

A

N: 4-6cm^2

SO: <2cm^2

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4
Q

Smallest MV Orifice Compatible With Life

A

0.3cm^2

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5
Q

[Pathophysiology of MS]

Left Atrium and Pulmonary Artery Wedge Pressure

A

Increased

Prominent A waves and gradual Y descent

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6
Q

[Pathophysiology of MS]

Left Ventricular End Diastolic Pressure

A

Normal in MS

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7
Q

[Pathophysiology of MS]

Cardiac Output

A

May be normal but generally worsens progressively

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8
Q

[Symptoms and Complications]

Mitral Stenosis

A
  1. Exertional Dyspnea, Orthopnea, PND
  2. Acute Pulmonary Edema
  3. Atrial Arrythmias
    4 Hemoptysis
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9
Q

[Physical Findings]

Inspection of Mitral Stenosis

A
  1. Malar flush with pinched and blue facies
  2. Prominent alpha waves in JVP in sinus rhythm
  3. Single c-v wave in AF
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10
Q

[Physical Findings]

Palpation of Mitral Stenosis

A
  1. Right ventricular tap with palpable S1

2. Diastolic Trill

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11
Q

[Physical Findings]

Auscultation of Mitral Stenosis

Describe:
S1
P2

A

Low-pitched, rumbling, diastolic murmur

Accentuated and Snapping S1
Accentuated P2 in pulmonary hypertension
Opening snap follows P2

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12
Q

[Laboratory Examination]

ECG of Mitral Stenosis

A

Left and Right Atrial Enlargement
Right Axis Deviation
Right Ventricular Enlargement

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13
Q

What is the most sensitive and specific non-invasive method for diagnosis of Mitral Stenosis?

A

Echocardiogram

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14
Q

Using cardiac catheterization should be applied in what age for Filipinos?

A

Males: > 55 yo
Females: > 60 yo

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15
Q

Mitral Regurgitation is commonly caused by?

A

Chronic RHD in 90% of Cases

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16
Q

Effect of MR on the LA and LV

A

Enlargement in both, the larger the LV gets, the worse the MR becomes

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17
Q

[Auscultation of Mitral Regurgitation]

Describe Murmur

A

Grade III/IV Holosystolic Murmur at Apex and Radiates to Axilla

18
Q

[Auscultation of Mitral Regurgitation]

Describe S sounds

A

S1 Absent or Soft
S2 Widely Split
S3 Due to sudden tensing of papillary muscles
S4 Audible

19
Q

What is the most sensitive and specific non-invasive method for diagnosis of Mitral Regurgitation?

A

Echocardiogram

20
Q

Why do you give vasodilators to people with MR?

A

Lower the afterload

21
Q

Define: Critical Aortic Stenosis

A

Peak systolic pressure gradient of 50mmHg

AV Area < 0.5 cm^2

22
Q

[Aortic Stenosis]
CO at Rest
CO with Exercise

A

Normal

Subnormal Rise

23
Q

Why do you not perform Percutaneous Balloon Aortic Valvuloplasty on the elderly?

A

Usually have calcifications and this might cause an embolism

24
Q

Marfan’s Syndrome usually causes what valvular disease?

A

Aortic Regurgitation

25
Q

[Auscultation of Aortic Regurgitation]

Describe Murmur

A

High-pitched, blowing, decrescendo diastolic murmur

26
Q

How do you intensify Aortic Regurgitation murmurs? How does this happen?

A

Handgrip Maneuver

Increases the afterload, causing more regurgitation to occur

27
Q

What would cause increase in the sound of a murmur in Tricuspid Stenosis?

A

Inspiration

Causes increased amounts of blood to flow into the heart, causing a larger sound

28
Q

Do you replace the Tricuspid Valve?

A

No, because low blood flow would make it prone to infection and increased chances of thrombus infection

29
Q

Why would Mitral Stenosis cause Hoarseness of Voice

A

Enlargement of LA can compress the Left Recurrent Laryngeal Nerve

30
Q

Pulsus parvus et tardus is found in which Valvular Disease?

A

Aortic Stenosis

31
Q

Bisferiens pulse is found in which Valvular Disease?

A

Aortic Stenosis

32
Q

Murmur heard in Aortic Stenosis

A

Systolic Crescendo-Decrescendo Murmur

33
Q

What is Demusset’s Sign

A

Jarring of entire body

Head bobbing with each systole

34
Q

What is Corrigan’s Pulse

A

“Water Hammer Pulse”

Collapses as arterial pressure falls rapidly during late systole and diastole

35
Q

What is Traube’s Sign

A

Pistol shot pulse heard over femoral artery

36
Q

What is Quicke’s Pulse

A

Capillary pulsations when pressure is applied to the nail

37
Q

What is Durozier’s Sign

A

To-and-fro murmur with femoral artery compression

38
Q

Austin-Flint Murmurs are heard during which kind of Valvular Disease?

A

Mitral Regurgitation

39
Q

Carvallo’s Sign is usually heard during what kind of Valvular Disease?

A

Tricuspid Regurgitation

40
Q

What is Carvallo’s Sign?

A

Holosystolic murmurs intensified by inspiration

[OS 213] CVS Module (33 decks)

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