Cardiology: Valvular Heart Disease Flashcards
Mid systolic murmur
2 RICS
aortic stenosis
Diastolic murmur
2-4 LICS
aortic regurgitation
Mid-late diastolic murmur
Apex
mitral stenosis
Pansystolic murmur
Apex
mitral regurgitation
Mid-late diastolic murmur
LLSB
tricuspid stenosis
Pansystolic murmur
LLSB
tricuspid regurgitation
Mid-systolic murmur
2-3 LICS
pulmonic stenosis
Early diastolic murmur
2 LICS
pulmonic regurgitation
What aids in listening for aortic stenosis?
leaning forward
squatting
What aids in listening for aortic regurgitation
leaning forward
full exhalation
What aids in listening for mitral stenosis
left lateral decubitus
full exhalation
What aids in listening for tricuspid stenosis
inspiration
squatting
What aids in listening for tricuspid regurgitation
inspiration
What aids in listening for pulmonic regurgitation?
inspiration
what do you expect to see on ECG, Echo and CXR for aortic stenosis
LVH
immobile calcified leaflets
post stenotic dilation of aorta
what do you expect to see on ECG, Echo and CXR for aortic regurgitation
LVH
impaired LV fxn
what do you expect to see on ECG Echo and CXR for mitral regurgitation
LAE, LVH
afib
RVH if severe
what do you expect to see on ECG, Echo and CXR for mitral stenosis
LAE
valve thickening
afib
RVH, Kerley B lines late sign
subvalvular aortic stenosis is often caused by…
HCM
most common level of aortic stenosis?
aortic valve
Early sxs of aortic stenosis
DOE
does early aortic stenosis present with chest pain?
no
late sxs of aortic stenosis
angina
syncope
heart failure
how often should repeat echo be performed in mild, moderate, and severe asymptomatic valve issues?
mild: 3-5 years, monitor sxs development
moderate: 1-2 years
severeL every 6-12 months, include cards
symptomatic aortic stenosis is treated with…
referral to CT surg or interventional cards
which type of prosthetic valve requires anticoagulation?
mechanical
which type of prosthetic valve lasts longer?
mechanical
HCM presents with the same murmur as AS, but is enhanced with…
standing
valsalva
MC cause of chronic aortic regurg…
aortic root dilation
MC valve disease causing chronic aortic regurg…
calcification
MC aortic regurg cause that occurs with valve disease and aortic root dilation…
bicuspid aortic valve
Acute aortic regurgitation presents with…
profound hypotension
cardiogenic shock
pulmonary edema
s/s of endocarditis/aortic dissection
chronic aortic regurgitation results in what physical manifestations on the heart?
gradual dilation and eccentric hypertrophy
wide pulse pressure
corrigan pulse
austin-flint murmur
these are physical exam findings indicative of…
aortic regurgitation
chronic aortic regurgitation presents with what findings on CXR?
LVH
Cardiomegaly
how is acute aortic regurg managed
emergent valve surgery
how is symptomatic chronic aortic regurgitation managed?
refer to CT surg or interventional cards
what is a common cause of chronic mitral regurgitation
connective tissue disorders
acute mitral regurgitation can be ischemic or non-ischemic.
ischemic causes include…
papillary muscle damage
acute mitral regurgitation can be ischemic or non-ischemic.
non-ischemic include
ruptured chordae tendineae
MVP, endocarditis, trauma, ARF
acute mitral regurgitation will present with…
very ill
pulmonary edema
hypotension
shock
chronic mitral regurgitation will present with…
heart failure sxs
pulmonary HTN
LAE, RVH
acute mitral regurgitation is manged with…
IV nitroprusside and urgent surgical consult
chronic nonischemic mitral regurgitation is managed medically for HTN, hypervolemia, and a.fib with..
HTN: ACE-I, vasodilators
hypervolemia: na restriction, diuretics
a. fib: warfarin with 2-3 INR, digoxin
Mitral valve prolapse is often asymptomatic, but can also present with…
atypical or non-anginal chest pain
what tx can be offered for mitral valve prolapse with palpitation or arrhythmia
beta blockers
what is the most common cause of mitral stenosis?
rheumatic heart disease
What can cause sxs in mitral stenosis?
exertion, excitement
fever
anemia
pregnancy
a. fib
what sxs are common with mitral stenosis?
sxs of LHF and RHF
hemoptysis
What can manage mild mitral stenosis?
diuretics and sodium restriction
if mitral stenosis occurs with afib, hx of emboli, or significant LAE, what tx should be offered?
warfarin (INR 2-3)
For progressing sxs of mitral stenosis, what can be done?
valve surgery
Generally, valvular stenosis is not a ______ process
not acute
Generally, valvular regurgitation can present as a ______ process
acute
What is the main tx goal for afib?
prevention of systemic embolization
what can be prescribed for patients with afib and a mechanical heart valve?
warfarin
what is included in rhythm control strategy for afib…
antiarrhythmic meds
ablation
surgery
what is included in a rate control strategy for afib?
beta blockers
non-dihydropyridine CCB
digoxin
