Cardiac diseases + valves Flashcards
Mitral regurg causes
Functional, annular calcification, rheumatic fever, IE
Mitral valve prolapse, ruptured chordae tendinae
Cardiomyopathy, connective tissue disorders
Appetite suppressants
Symptoms of Mitral regurg
Dyspnoea
Fatigue
Palpitations
Symptoms of causative factor
Signs of Mitral regurg
AF
Displaced, hyperdynamic apex
Pansystolic murmur at apex radiating to the axilla
Management of mitral regurg
Rate control B-blocker or rate limiting Ca blocker Add digoxin Then consider amiodarone Do not give b-blockers with verapamil Anticoagulate Prosthetic valve Diuretics to improve symptoms
Mitral valve prolapse causes
Very common Alone ASD, patent ductus arteriosus Cardiomyopathy Turner’s syndrome / Marfan’s Osteogenesis imperfecta WPW
Treatment for mitral valve prolapse
Beta-blockers help palpitations and chest pain
Surgery if severe
Causes of Mitral stenosis
Rheumatic fever, congenital
Mucopolysaccharidoses
Prosthetic valve
Malignant carcinoid
Signs of Mitral stenosis
Malar flush Tapping, non-displaced apex beat Fatigue, palpitations Chest pain Systemic emboli IE
Sounds of Mitral stenosis
Loud S1
Opening snap
Rumblish mid-diastolic murmur heard on expiration
Sounds of Mitral valve prolapse
Mid-systolic click or late systolic murmur
Sounds of mitral regurg
Pansystolic murmur at apex
Soft S1
Split S1
Loud P2
Sounds of aortic stenosis
Aortic thrill
Ejection systolic murmur
Sounds of Aortic sclerosis
Ejection systolic murmur
Sounds of aortic regurgitation
High pitched early diastolic murmur
Quincke’s sign
Causes of Aortic stenosis
Senile calcification, rheumatic heart disease
Causes of aortic sclerosis
Senile degeneration of the valve
Causes of acute Aortic regurg
IE
Ascending aortic dssection
Chest trauma
Causes of chronic aortic regurg
Congenital, connective tissue disorder
Takayasu arteritis, rheumatoid, SLE
HT
Sounds of tricuspid regurg
Pansystolic murmur
Sounds of tricuspid stenosis
Open snap + early diastolic murmur at left sternal edge
Sounds of pulmonary stenosis
Ejection click, ejection systolic murmur
Sounds of pulmonary regurg
Decrescendo mumur in early diastole
Causes of tricuspid regurg
Functional, rheumatic fever, IE
Causes of tricuspid stenosis
Rheumatic fever
Causes of pulmonary stenosis
Congenital
Rheumatic fever, carcinoid
Causes of Pulmonary regurg
Pulmonary HT
Symptoms and signs of Acute myocarditis
HF symptoms
Palpitations
Tachycardia
Soft S1
Causes of Acute myocarditis
Idiopathic Viral Bacterial Spirochaetes Protozoa Drugs Toxins Immunological
Symptoms of Dilated cardiomyopathy
Fatigue, dyspnoea
Pulmonary oedema, RVF
Emboli
Signs of Dilated cardiomyopathy
Inc pulse Dec BP Inc JVP Pleural effusion, Oedema, Ascitis Jaundice, Hepatomegaly
Treatment for Dilated cardiomyopathy
Bed rest
ACE-I, B-blockers, diuretics
Anticoagulation
Biventricular pacing, ICDs, LVADs, Transplantation
Symptoms and Signs of Hypertrophic cardiomyopathy
Sudden death, angina
Dyspnoea, palpitation, syncope
CCF
Treatment for Hypertrophic cardiomyopathy
Amiodarone, B-blockers
Anticoagulate
Causes of Restrictive cardiomyopathy
Idiopathic, amyloidosis
Haemochromatosis, sarcoidosis
Treatment for restrictive endocarditis
Treat the cause
Causes for Acute pericarditis
Viruses, bacteria, fungi + parasitic, autoimmune, drugs, metabolic
Others: trauma, surgery, radiotherapy, MI, malignancy, CHF
Treatment for Acute pericarditis
NSAIDs or aspirin with gastric protection
Add colchicine to reduce risk of recurrence
Causes of Pericardial effusion
Pericarditis, myocardial rupture, aortic dissection
Clinical ft of Pericardial effusion
Dyspnoea, chest pain
Local structures being compressed: hiccoughs (phrenic nerve), nausea (diagphragm), bronchial breathing at left base (left lower lobe)
Management of Pericardial effusion
Pericardiocentesis
Causes of constrictive pericarditis
Unknown, TB, after pericarditis
Management of Constrictive pericarditis
Surgical excision
Signs of cardiac tamponade
Increase pulse
Dec BP
Pulsus paradoxus
Inc JVP
Diagnosis of Cardiac tamponade
Beck’s triad
Dec BP
Inc JVP
Muffled heart sounds
Management of Cardiac tamponade
Pericardial effusion for drainage
Send for culture, ZN stain/TB culture
Cytology
