Cardiac Valve Defects Flashcards
What is S1?
Closure of the AV valves (mitral, tricuspid)
What is S2?
Closure of the semilunar valves (pulmonary, aortic)
How do you describe a murmur?
- Location (where heard loudest)
- When? Systolic/diastolic?
- Ejection (at the start)/ Pan (throughout)?
- Pitch?
- Radiation?
What is valve stenosis?
Failure of a valve to open completely, usually due to a chronic process.
What is valve regurgitation?
Failure of a valve to close completely which may be due to an acute/chronic process.
What are the causes of mitral regurgitation?
Mitral valve prolapse, infective endocarditis, post rheumatic fever, rupture of papillary muscle post-MI, LV dilation (stretching of valve ring).
What is the process occurring in acute mitral regurgitation?
- Sudden onset usually due to infective endocarditis/papillary muscle rupture post-MI.
- Heart does not have time to undergo compensatory changes.
- Blood backflows in the LA, increasing the pressure in the LA.
- Increases pressure in the pulmonary circulation = pulmonary oedema.
What is the process occurring in chronic mitral regurgitation?
- Dilation of mitral valve ring, prolapse, post-RF, or papillary muscle ischaemia.
- Heart has time to undergo compensatory changes.
- LA dilates without substantial increase in pressure, LV undergoes hypertrophy to mitigate effects of regurgitation.
- Asymptomatic for years, then decompensation and LVF.
What are the symptoms of chronic mitral regurgitation?
Dyspnoea, fatigue, palpitations, AF (due to dilated left atrium).
What is this describing?
Pansystolic murmur at apex radiating to axilla.
Mitral regurgitation
What is this describing?
Rumbling mid-diastolic murmur.
Mitral stenosis
What is this describing?
Malar flush, P mitrale (bifid P wave) on ECG (enlarged R atrium). Commonly caused by rheumatic fever.
Mitral stenosis
What causes tricuspid regurgitation?
Dilation due to pulmonary hypertension induced by LV failure, rheumatic fever, endocarditis especially from IVDU.
What are the symptoms of tricuspid regurgitation?
Fatigue, hepatic pain on exertion (hepatic congestion), ascites, oedema.
What is this describing?
Pansystolic murmur in tricuspid region.
Tricuspid regurgitation