Cardiac Valve Disfunction

Question 1

When is systole in relation to heart sounds?

Answer 1

Between the first and second heart sounds

Question 2

What is valve stenosis?

Answer 2

Narrowing of the valve

Question 3

What is the result of valve stenosis?

Answer 3

A pressure gradient across the valve and high pressure in the chamber behind the valve

Question 4

What is valve incompetence?

Answer 4

When valve doesn’t close properly and blood leaks

Question 5

What is the result of valve incompetence?

Answer 5

Increased EDV

Question 6

What causes a murmur?

Answer 6

Turbulence around a stenosed or incompetent valve

Question 7

What causes valvular heart disease?

Answer 7

rheumatic fever, degenerative conditions

Question 8

What is the result of valvular heart disease?

Answer 8

cardiac compensation (ventricular enlargment) that eventually fails

Question 9

What interventions are used to treat valvular heart disease?

Answer 9

Valve replacements, valve repair, balloon valvotomy, stent valves

Question 10

What happens in aortic stenosis?

Answer 10

fibrosis or calcification causes a progressive narrowing of the aortic valve

Question 11

What is the size reduction of the aortic valve in aortic stenosis?

Answer 11

2.5cm squared down to 0.7cm squared

Question 12

What is the pressure gradient across the valve in severe aortic stenosis?

Answer 12

50mmHg - LVP of 170/80

Question 13

Who does aortic stenosis mostly effect?

Answer 13

The elderly

Question 14

What are the symptoms of aortic stenosis?

Answer 14

SOB, chest pain, black outs

Question 15

What is the left ventricular response to aortic stenosis?

Answer 15

Concentric hypertrophy, leads to less compliance, leads to increased LVEDP, leads to increased LAP, can eventually lead to cardiac failure

Question 16

Are the left ventricular changes reversible?

Answer 16

Yes - after surgery

Question 17

When is surgery given for atrial stenosis?

Answer 17

When symptoms appear

Question 18

What type of murmur is heard for aortic stenosis?

Answer 18

An ejection systolic murmur - get louder as gradient increases - best heard at upper right sternal edge

Question 19

What are the two ways that aortic regurgitation can occur?

Answer 19

damage of leaflets or dilation of aortic root

Question 20

How are leaflets damaged?

Answer 20

Endocarditis or rhemuatic fever

Question 21

How is the aortic root dilated?

Answer 21

Marfan’s syndrome, aortic dissection, collagen vascular disorders, syphillis

Question 22

What happens in aortic regurgitation?

Answer 22

Blood leaks back into the ventricle during diastole, LV has to pump greater SV, leads to an increased EDV and increased ejection fraction, reduced aortic pressure in diastole means there is a wide pulse pressure

Question 23

What eventually happens in aortic regurgitation?

Answer 23

LV function decreases - eccentric hypertrophy - decompensation - leads to irreversible changes

Question 24

What kind of murmur is heard for aortic regurgitation?

Answer 24

A diastolic murmur - can’t hear second heart sound because valve isn’t closing properly

Question 25

What are the causes of mitral valve regurgitation?

Answer 25

myxomatous degenration, ruptured chordae tendinae, endocarditis, myocardial infarct that effect papillary muscle, rheumatic fever, collagen vascular disease, cardiomyopathy

Question 26

What happens in mitral regurgitation?

Answer 26

Blood flows back in left atrium, left ventricle has to pump greater stroke volume, increased LVEDV, increase LAP, atrial fibrillation, pulmonary oedema

Question 27

What murmur is heard in mitral regurgitation?

Answer 27

A pan systolic murmur

Question 28

What causes mitral stenosis?

Answer 28

Almost always rheumatic fever

Question 29

What happens in mitral stenosis?

Answer 29

reduced filling of the LV, increased LAP and LAV, atrial fibrillation, pulmonary congestion