Cardio- Valvular Heart Disease Flashcards
What is the best initial test for a patient in who valvular heart disease is suspected
Echo
What is the most accurate test for diagnosing valvular heart disease
Cardiac catheter
What is the number one cause of mitral stenosis
Rheumatic fever secondary to untreated Group A beta hemolytic strep
What kind of murmor is mitral stenosis
Diastolic
How can embolus form due to mitral stenosis
Flow from left atrium decreases leading to stasis leading to embolus formation
What is ortman sign
Hoarseness associated with mitral stenosis
Where is mitral stenosis best heard
Apex
Tx of mitral stenosis
Preload reduction w Na restricted diet, diuretic(furosemide)
If afib then give digoxin and warfarin
If necessary then sx -> ballon vavuloplasty or valve replacement
Main cause of mitral regurg
Main cause is ischaemia or infarction leading to dilation which separates valve leaflets
What type of murmor is mitral regurg
Holosystolic
What is an acute cause of mitral regurg
Acute cause of mitral regurg is rupture of chordae tendinae likely seen post MO 2-5 days after- sudden rapid dyspnea so send for echo (confirm diagnosis ) and surgery immediately
Treatment of mitral regurg
Surgery if post mi, diuretics
Non emergent chronic cases: after load reduction with nitrates(nitroglycerin) and or acr i for eg captopril
If afib then digoxin and warfarin
Surgery if left ventricular ejection fraction less than 60%
Main cause of aortic stenosis
Aging
What kind of murmor is aortic stenosis
Murmor will be systolic crescendo decrescendo
Clinical picture of aortic stenosis
CHF like symptoms, chest pain
Systolic ejection murmor, paradoxical s2 slitting, pulsus tardus et parvus, carotid thrill, may s4 murmor
