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Pathoma Rev > Cardiac Murmurs > Flashcards

Cardiac Murmurs Flashcards

1
Q

What are the sounds of an aortic regurg murmur?

A

Early, blowing diastolic murmur

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2
Q

What are the characteristics of the murmur heard in mitral stenosis?

A

Opening snap, followed by a diastolic rumble

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3
Q

What is the cause of a paradoxical embolus?

A

ASD allows a thrombus to cross over to the systemic circulation as opposed to the pulmonary

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4
Q

When does aortic stenosis usually present?

A

Late adult life

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5
Q

What is the key bacteria that causes endocarditis of prosthetic valves?

A

Staph Epidermidis

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6
Q

What is the anemia that is caused by aortic stenosis? How does it cause this?

A

Microangiopathic hemolytic anemiaRupture of the RBCs as they pass the stenotic area

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7
Q

What, usually, is the cause of mitral regurg?

A

Complication secondary to mitral valve prolapseOr can be from LV dilation

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8
Q

What are the characteristics of the murmur produced from mitral valve prolapse?

A

Mid-Systolic click

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9
Q

How do you differentiate aortic stenosis secondary to rheumatic valve disease, and the “wear and tear” etiology?

A

Rheumatic valve disease has coexisting mitral valve stenosisAortic valve with have fusion of the commissures with rheumatic heart disease

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10
Q

What other congenital condition of the adult form of coarctation of the aorta associated with?

A

Bicuspid aortic valve

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11
Q

Why are angina and syncope common with aortic stenosis?

A

Inability to get blood across the valve to the heart and coronaries

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12
Q

What is the drug that can be administered to maintain an open PDA?

A

PGE

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13
Q

What is the hallmark appearance of the aortic valve stenosis in chronic rheumatic fever?

A

“fish-like”

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14
Q

What is the immediate treatment for transposition of the great vessels?

A

PGE to maintain PDA

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15
Q

What is the most common CHD? What is it associated with?

A
  • VSD

- Fetal alcohol syndrome

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16
Q

What causes the increase in intensity of a mitral regurgitation murmur with expiration?

A

Expiration leads to increased venous return to the LA and LV, meaning more blood is regurgitated

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17
Q

When in the heart cycle does aortic regurgitation occur?

A

Diastole

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18
Q

What is the long term sequale with a VSD?

A

L to R shunt will cause pulmonary HTN until there is lower pressure in the LV, forcing deoxygenated blood to the systemic system

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19
Q

What about damaged valve leads to the development of endocarditis?

A

Damaged endocardial surface develops thrombotic vegetations, allowing for the trapping of bacteria within the vegetations

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20
Q

What is the treatment for small and large VSDs?

A

Large need surgical closure, small usually regress on their own

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21
Q

What infectious disease is PDA associated with? What are the other s/sx of this congenital infection?

A

Congenital rubella

  • PDA
  • Cataracts
  • Sensorineural deafness
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22
Q

What is Eisenmenger syndrome? What may the kidneys do to counteract the hypoxemia

A

RVH from chronic stress of excess bloodPolycythemia d/t chronic hypoxia from a VSD

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23
Q

What happens if the mitral valve is affected in chronic rheumatic fever?

A

Fusion of the commissures, causing stenosis

24
Q

—What are the three major complications associated with mitral stenosis?—-

A

——Pulmonary congestion-Pulmonary HTN-A-fib—–

25
Q

What is the treatment for aortic stenosis? When is this performed?

A

Valve replacement after the onset of complications

26
Q

What is the treatment for aortic regurg?

A

Valve replacement when LV dysfunction develops

27
Q

What is the usual cause of mitral stenosis?

A

Chronic rheumatic valve disease

28
Q

What is the natural history of a PDA (specifically before and after the pulmonary artery changes occur)?

A

shunting of blood from the pulmonary artery to the aorta initially causes pulmonary overload, and pHTN. The shunt reverses when this gets high enough, causing deoxygenated blood to flow to the aorta, resulting in peripheral cyanosis

29
Q

Which valve is the one classically infected by staph Aureus?

A

tricuspid

30
Q

What is the cause of aortic stenosis?

A

Wear and tear on the valve

31
Q

What is the most common type of an ASD? What genetic disorder is this highly associated with?

A 
Ostium secundum
Down syndrome (THIS IS PRIMUM, thus this card is half-incorrect)
32
Q

—What is Libman-Sacks endocarditis?—

A

—Sterile vegetations associated with SLE, the results on vegetations present on both sides of the mitral valve—

33
Q

What happens to the chordae tendineae and cusps of the mitral valve in chronic rheumatic fever?

A

Thickening

34
Q

What is the preferential area affected with endocarditis secondary to rheumatic fever?

A

Endocardium (usually Mitral valve or sometime Aortic)

35
Q

True or false: small VSDs are usually asymptomatic

A

True

36
Q

What are the complications of mitral valve prolapse?

A

Infectious endocarditisArrhythmiaSevere mitral regurg

37
Q

What occurs in the heart with tricuspid atresia?

A

Failure of the tricuspid valve to develop, leading to RV hypoplasia. ASD leads to a R to L shunt

38
Q

What causes the increase in wedge pressure with aortic regurg?

A

Large increase in SBP d/t LVH, lower DBP d/t backflow of blood

39
Q

What causes the murmur in endocarditis?

A

Vegetation of the valves disrupts flow

40
Q

What muscles, when damaged during an MI, can lead to mitral valve prolapse?

A

Papillary muscles

41
Q

What causes the click heard in mitral valve prolapse?

A

Ballooning back of the mitral valve into the atrium

42
Q

What inherited diseases is mitral valve prolapse associated with?

A

Ehlers-Danlos syndrome or Marfan’s

43
Q

What is the basis for using indomethacin for closing a PDA?

A

Decreases PGE, resulting in PDA closure

44
Q

What particular congenital disorder increases the risk of developing aortic stenosis? Why?

A

Bicuspid aortic valvenow two cusps are doing the work of three

45
Q

What are the two causes of aortic regurgitation?

A

Aortic root dilation (increases space between the valves) or valve damage

46
Q

What happens to the heart sounds with ASDs? Why?

A

Fixed splitting of S1 and S2, since LA has a consistent volume, regardless of inspiration or not

47
Q

What is chronic rheumatic valve disease?

A

Valve scarring that results from rheumatic fever that usually results in stenosis with a “fish-like” appearance

48
Q

What are the four components of the TOF?

A
  1. VSD
  2. Pulmonary stenosis
  3. Overriding aorta
  4. RVH
49
Q

What are the characteristics of the murmur found in mitral valve regurgitation? What can increase the intensity of the sound?

A

Holosystolic “blowing” murmur, with squatting and expiration increasing the sound

50
Q

What are the hyperdynamic findings of aortic regurgitation? Why does these occur?

A

bounding pulses, pulsating nail bed, head bobbingLarge increase in SBP

51
Q

What does the compensation of aortic stenosis (of any etiology) lead to?

A

Systolic ejection click, crescendo-decrescendo followed by a murmur.LV hypertrophy

52
Q

What is the cause of mitral valve prolapse?

A

Degeneration of the mitral valve, making it more floppy than usual

53
Q

What is the treatment for mitral valve prolapse?

A

Valve replacement

54
Q

What is the murmur that is found with PDA?

A

Holosystolic, machine-like murmur

55
Q

What is nonbacterial thrombotic endocarditis? What valve do the vegetations usually form on?

A

Sterile vegetations that arise with hypercoagulable state or underlying adenocarcinomaMitral valve along the lines of closure

56
Q

What happens to the LV in aortic regurgitation?

A

Dilation and eccentric hypertrophy

Pathoma Rev (4 decks)

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