Aortic stenosis

Question 1

what is aortic stenosis characterised by

Answer 1

obstruction of left ventricular outflow lowering cardiac outflow
usually asymptomatic

stenosis results in decreased flow so decreased cardiac output due to stenosis

Question 2

mitral is only valve with what

Answer 2

2 leaflets

bicuspid

Question 3

3 cardinal signs of aortic stenosis

Answer 3

dizziness os syncope on exertion
exertion dysponoae
extertional angina

ejection systolic murmur

Question 4

what happens to the carotid pulse in aortic stenosis

Answer 4

rises slowly and is a weak

Question 5

what does aortic stenosis sound like on auscultation

Answer 5

on auscultation of 2nd intercostal space and we have reduced intensity of second heart sound - i.e. when the valves close

murmur in aortic stenosis in S1 then blood squeezes through aortic valves slowly - ejection systolic murmur
AV vapes close then tuberulance as blood through aortic valve then it closes
this murmur can radiate to the carotid

Question 6

S1

Answer 6

blood in ventricles and AV valves close

Question 7

S2

Answer 7

blood through aortic valves and close

Question 8

what is it called the period between S1 and S2

Answer 8

systole - ventricles contracting

diastole is S2- S1

Question 9

what are the 3 aitologies of aortic stenosis

Answer 9

congenital abnormal valve( UNICUSPID OR BICUSPID)
calcification of aortic valve
rheumatic valvular heart disease

Question 10

HOW do you manage aortas stenosis

Answer 10

surgical valve replacement
mechanical or bioprodsthestic
ballon valvuloplasty

Question 11

mitral regurgitation

Answer 11

leakage of blood backward through mitral valve each time left ventricle contracts

Question 12

mitral valve normally

Answer 12

allows ventricles to fill with blood

Question 13

where does the murmur from mitral regurgitation usually radiate too

Answer 13

left axillary region

A narrowed or stenotic valve requires the heart to pump harder, which can strain the heart and reduce blood flow to the body. A regurgitant (incompetent, insufficient, or leaky) valvedoes not close completely, letting blood move backward through the valve

Question 14

during diastole the heart with regurgitation is able to fill the ventricles will blood however during systole what happens

Answer 14

mitral cannot close properly - blood ejected back to left atria - resulting in blood travelling back to pulmaory system and pulmonary oedema dn increased pulmonary hypertension
also can have development of AF

Question 15

acute mitral regurtitiaon Sx

Answer 15

more aggressive 
SX 
fatigue 
diaphorreiss 
palpitaitons 
dyspnoea on exertion 
low extremity oedema 

listen at apex - 5th
S2-S1 diastole

Question 16

when are the murmurs heard in mitral regurgitation

Answer 16

systole - as not closed - but hear murmur through whole of systole - fat continuous murmur - called pan/holosytolic murmur
radiating to left axilla

diminished S1 heart sounds (closing of the mitral valve) - murmur is flat and continuous

Question 17

Investigation for mitral regurgitation

Answer 17

ECG- AF shown so no P waves
Ultrasound echocardiograms is gold standard

mitral valve prolapse
rheumatic fever group A strep - antibodies attach to heart valves
endocarditis
mitral valve calcification
cordi tendinae or papillary muscle dysfunction during MI leading to mitral regurgitation

cardiomyopathy - management included diabetes preoperative diametric
valvular pasty - catheter

mechanical( younger as last longer) or bioprostheic
intra aortic blallon