Cardiac Valve Disease Flashcards
There is a tapping apex beat in ___1___
There is a displaced and diffuse apex beat in ___2_____ There is a heaving and possibly displaced apex beat in ____3____
1 mitral stenosis
2 left ventricular dilatation
3 left ventricular hypertrophy
A left parasternal heave suggests
Right ventricular overload due to cor pulmonale or pulmonary hypertension
Pulmonary hypertension can be caused by mitral regurgitation
A cardiac murmur is…
Audible turbulence of blood flow
Systolic murmurs
Aortic stenosis and mitral regurgitation
Diastolic murmurs
Aortic regurgitation and mitral stenosis
Patent ductus arteriosus murmur
continuous machinery noise
Diastolic murmurs are always ___1____
Innocent murmurs are soft and in ___2__ usually best heard in ___3____ area, innocent murmurs do not __4___
1 pathological
2 systole
3 pulmonary
4 radiate
3 common causes of aortic stenosis?
Degenerative (age related)- the valve becomes calcified
Congenital bicuspid valve that degenerates quicker
Rheumatic heart disease- fairly uncommon now
Symptoms of aortic stenosis?
chest pain and syncope particularly on exertion
breathlessness
Describe aortic stenosis murmur
Ejection systolic murmur that can radiate to the carotids.
Mechanical valves tend to be offered to ____1____ as these require ___2____
Tissue valves tend to be offered to ___3___ as these _____4___
1 younger patients
2 lifelong warfarin
3 elderly patients
4 don’t require lifelong warfarin
aortic stenosis egg may show
LVH
Mitral regurgitation can occur due to abnormalities in (5)
valve leaflets the annulus chord tendinae papillary muscles left ventricle
Most common causes of mitral regurgitation are
degenerative disease (myxomatous)
papillary muscle rupture due to ischaemia
rheumatic heart disease
endocarditis
symptoms of mitral regurgitation
palpitations
dyspnoea and orthopnoea
fatigue and lethargy
In mitral regurgitation the apex beat will be
displaced
In mitral regurgitation the CXR will show, the ECG will show
cardiomegaly
LVH
Murmur of mitral regurgitation is
pansystolic murmur that may radiate to the axilla
Left sided murmurs are best heard in ?
Right sided murmurs are best heard in?
expiration
inspiration
Most common cause of mitral stenosis _____ this is secondary to _____
very rarely caused by _____
rheumatic fever secondary to infection with Group A Streptococcus
congenital heart disease
Presentation of mitral stenosis
Breathlessness
Palpitations
Malar flush
In mitral stenosis there may be a ____ apex beat
tapping
murmur of mitral stenosis
rumbling mid-diastolic murmur localised to the apex
Mitral stenosis may cause _____ due to enlargement of ______
AF
left atrium
On CXR for mitral stenosis
Straight left heart border due enlargement of the left atrium
Causes of Aortic Regurgitation?
Leaflet damage due to endocarditis
Annulus damage due to Marfans or aortic dissection
Collapsing pulse with a wide pulse pressure is a sign of
aortic regurgitation
Wide pulse pressure and displaced apex is a sign of
aortic regurgitation
murmur for aortic regurgitation
early diastolic murmur best heard on the left sternal edge with the patient leaning forwards on expiration
What type of pulse do you get in aortic stenosis? Why?
Low volume pulse that is slow rising as ejection is prolonged
When will you feel symptoms of Aortic regurgitation? Why does this happen?
Tend not to feel symptoms until you get left ventricular failure, you get reduced coronary perfusion due to reflux through valve during diastole
In cardio exam when you sit patient up and hold stethoscope to left sternal edge and listen on expiration what you are listening for?
Aortic Regurgitation
When you turn patient to left and listen to apex what are you listening for?
Mitral stenosis
All common murmurs as on the left side will be best hear on
expiration
