Cardiology Flashcards
Aortic Stenosis
- causes
- findings
Senile calcification, congenital (bicuspid valve, William’s syndrome),
Slow rising pulse with narrow pulse pressure
aortic thrill
ejection systolic murmur > carotids
Mitral stenosis
Rheumatic, congenital,
mid-late diastolic murmur
malar flush
atrial fibrillation
Mitral Valve Regurgitation causes
Functional (LV dilatation) annular calcification (elderly) mitral valve prolapse ruptured chordae tendinae papillary muscle dysfunction/rupture connective tissue disorders (Ehlers–Danlos, Marfan’s
Mitral Valve Regurgitation murmur
pansystolic murmur
Mitral Valve Prolapse
Mid-systolic click
Aortic Stenosis management
symptomatic - valve replacement
valvular gradient > 40 mmHg + features such as LVSD - consider surgery
angiogram prior as combined surgery
Aortic sclerosis
senile degeneration
ejection systolic murmur
no carotid radiation and normal pulse (character and volume) and S2.
Aortic regurgitation
signs
Collapsing (water-hammer) pulse - due to hyperdynamic circulation
wide pulse pressure -high sys increased pressure to stable CO,, low dia due to regurge
displaced, hyperdynamic apex beat
high-pitched early diastolic murmur (expiration, sitting forward)
Corrigan’s sign: carotid pulsation
de Musset’s sign: head nodding with each heartbeat
Quincke’s sign: capillary pulsations in nail beds
Austin Flint murmur denotes severe AR.
Tricuspid regurgitation
Giant a wave and slow y descent in JVP
pansystolic murmur
Pulmonary stenosis
Usually congenital (Turner’s syndrome, Noonan’s syndrome,
William’s syndrome, Fallot’s tetralogy, rubella
prominent a wave in JVP
ejection systolic murmur
Pulmonary regurgitation
any cause of pulmonary hypertension
A decrescendo murmur is heard in early diastole
HACEK > IE
HACEK Gram –ve bacteria (Haemoph ilus–Actinobacillus–Cardiobacterium–
Eikenella–Kingella)
AAA causes
HTN, smoking
CTD, syphillis
AAA tx
Elective surgery: aneurysms ≥5.5cm or expanding at >1cm/yr, or symptomatic aneurysms
Thoracic aortic dissection
Blood splits the aortic media >sudden tearing chest pain
dissection extends, branches of the aorta occlude sequentially >hemiplegia (carotid artery), unequal arm pulses and BP or acute limb ischaemia,
paraplegia (anterior spinal artery), and anuria (renal arteries).
Aortic valve incompetence, inferior MI and cardiac arrest may develop if dissection moves proximally.
Type A (70%) dissections involve the ascending aorta, irrespective of site of the tear,
whilst if the ascending aorta is not involved it is called type B (30%) All patients
with type A thoracic dissection should be considered for surgery: get urgent cardiothoracic
advice.
