6. Valves, Malformations, Endocarditis and Arrhythmias

Question 1

What valves can valve disease affect

Answer 1

Any of the four

Question 2

Most common valves affected and why (2)

Answer 2

Left side valves

Work at highest pressure

Question 3

Aetiology of valve disease (4)

Answer 3

Congenital abnormality
MI
Rheumatic fever
Dilation of aortic root (aneurysm formation, syphilis)

Question 4

Valve disease investigations

Answer 4

Ultrasound of heart chambers and valves

Question 5

Valve disease treatment

Answer 5

Replacement valve - mechanical or porcine

Question 6

Pros/cons of mechanical heart valves (2)

Answer 6

Last longer

Require immunosuppressants

Question 7

Complication of replacement heart valve

Answer 7

Development of endocarditis

Question 8

Examples of congenital heart defects (4)

Answer 8

Atrial septal defects
Ventricular septal defects
Patent ductus arteriosus
Great vessel malformations

Question 9

Definition of cyanosis

Answer 9

Bluish/purplish discolouration of skin/mucous membranes

Question 10

Cause of cyanosis

Answer 10

Tissue near skin surface having low oxygen saturation

Question 11

Types of central cyanosis and distinguishing features (2)

Answer 11

Central - around core, lips, tongue

Peripheral - extremities or fingers

Question 12

Causes of cyanosis (2)

Answer 12

Central - congenital heart disease

Peripheral - cold environment

Question 13

Diagnosis of cyanosis

Answer 13

5g/dl or more deoxygenated Hb in blood

Question 14

Cyanosis symptoms (2)

Answer 14

Bluish/purple lips, gums, skin, mucous membranes

Finger clubbing

Question 15

Cause of infective endocarditis

Answer 15

Microbial colonisation of thrombi on endocardial surface

Question 16

Symptoms and signs of IE (7)

Answer 16

Fever
Heart murmur
Embolic phenomena
Skin manifestations (petechiae/splinter haemorrhage)
Splenomegaly
Septic complications
Mycotic (infective) aneurysm

Question 17

Effects of IE (2)

Answer 17

Prolonged antibiotic treatment

Cardiac valve damage

Question 18

Types of cardiac arrhythmias (2) and examples (4)

Answer 18

Tachy - fast - AF, VT

Brady - slow - heart block, drug induced

Question 19

Treatment of Brady-arrhythmias

Answer 19

Pacemakers

Question 20

Ventricular fibrillation definition

Answer 20

Heart quivers instead of pumping due to disorganised electrical activity in ventricles

Question 21

VF causes (4)

Answer 21

MI
Electrocution
Long AT syndrome
Wolf-Parkinson-White syndrome

Question 22

VF results (3) and treatment

Answer 22

Cardiac arrest
Loss of consciousness
No pulse
Defibrillation

Question 23

Asystole definition (2)

Answer 23

Absence of ventricular contractions lasting longer than the max time sustainable for life (2s humans)
Usually irreversible

Question 24

AF definition

Answer 24

Abnormal heart rhythm characterised by rapid and irregular beating of atria

Question 25

AF symptoms (6)

Answer 25

Often none
Palpitations
Fainting
Light-headedness
SoB
Chest pain

Question 26

AF leads to increased risk of (3)

Answer 26

HF
Dementia
CVA