Cardiology: Types of Valvular Heart Disease

Question 1

name etiology of aortic stenosis

Answer 1

most often seen in elderly

unicuspid and bicuspid valves can lead to symptoms in childhood and adolescence

Question 2

name history of pt with aortic stenosis

Answer 2

may be asymptomatic for yrs
angina to syncope to CHF to death within 5yrs
ACS (angina, CHF, Syncope)

Question 3

what are PE findings in aortic stenosis

Answer 3

pulsus parvus et tardus (weak, delayed carotid upstroke) and a single or paradoxically split S2 sound; systolic murmur radiating to the carotids

Question 4

name how aortic stenosis diagnosed?

Answer 4

ECHO

Question 5

name treatment for aortic stenosis

Answer 5

aortic valve replacement

Question 6

name etiology of acute aortic regurgiation

Answer 6

acute: ineffective endocarditis, aortic dissection, chest trauma

Question 7

name etiology of chronic aortic regurgiation

Answer 7

chronic: valve malformations, rheumatic fever, connective tissue disorders

Question 8

name symptoms of acute aortic regurigtation

Answer 8

rapid onset of pulmonary congestion, cardiogenic shock, and severe dyspnea

Question 9

name symptoms of chronic aortic regurgitation

Answer 9

slowly progressive onset of dyspnea on excertion, orthopnea, and PND

Question 10

name PE findings in pts with aortic regurgitation

Answer 10

blowing diastolic murmur at the left sternal border, mid diastolic murmur

Question 11

name 3 signs in aortic regurgitation that are caused by widened pulse pressure

Answer 11

• de Musset’s sign: head bob with heartbeat
• Corrigan’s sign: water hammer pulse
• Duroziez’s sign: femoral bruit

Question 12

name treatment for aortic regurgitation

Answer 12

vasodilator therapy (dihydropyridines or ACEIs) for isolated aortic regurgitation until symptoms become severe enough to warrant valve replacement

Question 13

name mc etiology of mitral valve stenosis

Answer 13

mc cause is rheumatic fever

Question 14

name the symptoms of mitral valve stenosis

Answer 14

dyspnea, orthopnea, and PND to infective endocarditis and arrhythmias

Question 15

name PE findings in mitral valve stenosis

Answer 15

opening snap and mid diastolic murmur at the apex, pulmonary edema

Question 16

name treatment for mitral valve stenosis

Answer 16

antiarrhythmics (beta-blockers, digoxin) for symptomatic relief; mitral balloon valvotomy and valve replacement are effective for severe cases

Question 17

name etiology of mitral valve regurgitation

Answer 17

primary secondary to rheumatic fever to chordae tendineae rupture after MI. infective endocarditis

Question 18

name symptoms in mitral valve regurgitation

Answer 18

dyspnea, orthopnea, and fatigue

Question 19

name PE findings of mitral valve regurgitation

Answer 19

holosystolic murmur radiation to the axilla

Question 20

name treatment for mitral valve regurgitation

Answer 20

antiarrhythmics if necessary (AF is common with LAE nitrates and diuretics to decrease preload). valve repair or replacement for severe cases