Aortic Valve Disease

Question 1

what is the classic triad of symptoms for aortic stenosis?

Answer 1

angina
dyspnea
syncope

Question 2

what is the most common form of aortic stenosis?

Answer 2

valvular

Question 3

what is the normal aortic valve area?

Answer 3

3-4 cm squared

Question 4

at what valve area is aortic stenosis defined as critical?

Answer 4

< 0.7 cm squared

Question 5

what ventricular problem does aortic stenosis lead to?

Answer 5

increased wall stress and LVH

Question 6

what are the survival rates for patients with angina, syncope and heart failure with AS?

Answer 6

angina is 5 years
syncope is 3 years
HF is 2 years

Question 7

does intensity of AS murmur correlate with severity?

Answer 7

no

Question 8

at what valve area is aortic stenosis considered mild?

Answer 8

> 1.5 cm squared

Question 9

at what valve area is aortic stenosis considered moderate?

Answer 9

1-1.5 cm squared

Question 10

at what valve area is aortic stenosis considered severe?

Answer 10

< 1 cm squred

Question 11

what is pulsus parvus et tardus?

Answer 11

delayed and diminished carotid pulse from aortic stenosis

Question 12

is medical therapy effective for severe symptomatic AS?

Answer 12

no

Question 13

what are the goals for medical treatment in a patient with asymptomatic AS?

Answer 13

prevent CAD
maintain sinus rhythm
good BP control

Question 14

what patient population is a percutaneous aortic balloon valvuloplasty good for?

Answer 14

pediatrics with noncalcific AS, it normally lasts 10 years

in adults, restenosis often occurs within 6 months

Question 15

what does TAVR stand for?

Answer 15

transcatheter aortic valve replacement

Question 16

what is the most common cause of aortic stenosis?

Answer 16

age related calcification

Question 17

what is the treatment of choice for a patient with symptomatic aortic stenosis?

Answer 17

aortic valve replacement

Question 18

what is the classic murmur for aortic regurgitation?

Answer 18

soft blowing decrescendo murmur at LUSB

Question 19

what treatment is absolutely contraindicated in aortic regurgitation?

Answer 19

intra-aortic balloon pump

Question 20

while waiting for surgery, what two treatments can be done for a patient with aortic regurgitation?

Answer 20

inotropic and afterload reduction

Question 21

if a patient has chest pain with aortic regurgitation, what should you think of

Answer 21

aortic dissection

Question 22

what are two causes of chronic aortic regurgitation?

Answer 22

rheumatic heart disease

congenital bicuspid aortic valve

Question 23

does aortic regurgitation cause volume, or pressure overload?

Answer 23

volume overload

Question 24

what is the best determinant of postoperative left ventricular function?

Answer 24

left ventricular end systolic dimension (LVESD)

Question 25

what LVESD predicts poor prognosis postoperatively?

Answer 25

> 55 mm

Question 26

what is the main physical sign of aortic regurgitation?

Answer 26

increased pulse pressure

Question 27

what is DeMusset’s sign?

Answer 27

head bob with each heartbeat

Question 28

what is Traube’s sign?

Answer 28

pistol shot sound heard over femoral arteries

Question 29

what is Muller’s sign?

Answer 29

systolic pulsation of the uvula

Question 30

what is Quincke’s sign?

Answer 30

capillary pulsations visible in luluna

Question 31

what is Hill’s sign?

Answer 31

popliteal cuff systolic pressure > brachial cuff systolic pressure more than 60 mmHg

Question 32

when listening to a murmur from AR, what determines the severity of the regurg?

Answer 32

duration of the murmur

Question 33

in what patient populations would you use a bioprosthetic valve?

Answer 33

elderly

females of child-bearing age