6.6 MTB Step 3 - Valvular Heart Disease (VSD & ASD) Flashcards

1
Q

VENTRICULAR SEPTAL DEFECT (VSD)

  1. Describe the Murmur of VSD in Asymptomatic patients.
  2. What is (1) potential Symptom in a patient with a Larger Defect?
  3. Which (3) Maneuvers Worsen (Increase the Intensity of) the Murmur of VSD?
A
  1. Holosystolic Murmur
    • ​​Heard best at the Lower Left Sternal border.
  2. Shortness of Breath (SOB)
  3. Exhalation, Squatting, Leg Raise
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2
Q

VENTRICULAR SEPTAL DEFECT (VSD)

  1. What is the Best INITIAL Diagnostic Test for VSD?
  2. What is the Most Precise Diagnostic Test is used to determine the Degree of Left-to-Right Shunting?
A
  1. Echocardiography
  2. Catheterization
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3
Q

VENTRICULAR SEPTAL DEFECT (VSD)

  1. What is the Treatment for Mild Defects?
  2. What is the Treatment for More Severe Defects?
A
  1. Mild Defects: can be left without closure
  2. More Severe Defects: Mechanical Closure
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4
Q

ATRIAL SEPTAL DEFECT (ASD)

  1. What is the Clinical Manifestation of Small ASDs?
  2. What is the Clinical Manifestation of Larger ASDs?
A
  1. Asymptomatic
  2. Shortness of Breath (SOB) or signs of Right Ventricular Failure (e.g., SOB and a Parasternal Heave)
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5
Q

ATRIAL SEPTAL DEFECT (ASD)

What is the Most Frequently Tested Knowledge about ASD?

A

Fixed Splitting of S2 heart sound.

S2 Splitting is caused by Different Pressures on Different Sides of the Heart (same pressure on both sides = NO splitting)

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6
Q

ATRIAL SEPTAL DEFECT (ASD)

What is the Best Diagnostic Test for ASD?

A

Echocardiogram

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7
Q

ATRIAL SEPTAL DEFECT (ASD)

What are the (2) Best INITIAL Therapy Devices used for ASD?

A

Percutaneous devices

or

Catheter devices

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8
Q

ATRIAL SEPTAL DEFECT (ASD)

When is Repair most often Indicated for ASD?

A

Shunt Ratio > 1.5 : 1

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9
Q

ATRIAL SEPTAL DEFECT (ASD)

What are (4) Causes of Wide Splitting of S2 (P2 Delayed)?

A
  1. Right Bundle Branch Block (RBBB)
  2. Pulmonic Stenosis
  3. Right Ventricular Hypertrophy (RVH)
  4. Pulmonary Hypertension
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10
Q

ATRIAL SEPTAL DEFECT (ASD)

What are (4) Causes of Paradoxical Splitting of S2 (A2 Delayed)?

A
  1. Left Bundle Branch Block (LBBB)
  2. Aortic Stenosis (AS)
  3. Left Ventricular Hypertrophy (LVH)
  4. Hypertension (HTN)
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