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Clinical Medicine II > Cardiology: Valvular Heart Disease > Flashcards

Cardiology: Valvular Heart Disease Flashcards

1
Q

Mid systolic murmur

2 RICS

A

aortic stenosis

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2
Q

Diastolic murmur

2-4 LICS

A

aortic regurgitation

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3
Q

Mid-late diastolic murmur

Apex

A

mitral stenosis

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4
Q

Pansystolic murmur

Apex

A

mitral regurgitation

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5
Q

Mid-late diastolic murmur

LLSB

A

tricuspid stenosis

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6
Q

Pansystolic murmur

LLSB

A

tricuspid regurgitation

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7
Q

Mid-systolic murmur

2-3 LICS

A

pulmonic stenosis

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8
Q

Early diastolic murmur

2 LICS

A

pulmonic regurgitation

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9
Q

What aids in listening for aortic stenosis?

A

leaning forward

squatting

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10
Q

What aids in listening for aortic regurgitation

A

leaning forward

full exhalation

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11
Q

What aids in listening for mitral stenosis

A

left lateral decubitus

full exhalation

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12
Q

What aids in listening for tricuspid stenosis

A

inspiration

squatting

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13
Q

What aids in listening for tricuspid regurgitation

A

inspiration

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14
Q

What aids in listening for pulmonic regurgitation?

A

inspiration

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15
Q

what do you expect to see on ECG, Echo and CXR for aortic stenosis

A

LVH

immobile calcified leaflets

post stenotic dilation of aorta

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16
Q

what do you expect to see on ECG, Echo and CXR for aortic regurgitation

A

LVH

impaired LV fxn

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17
Q

what do you expect to see on ECG Echo and CXR for mitral regurgitation

A

LAE, LVH

afib

RVH if severe

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18
Q

what do you expect to see on ECG, Echo and CXR for mitral stenosis

A

LAE

valve thickening

afib

RVH, Kerley B lines late sign

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19
Q

subvalvular aortic stenosis is often caused by…

A

HCM

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20
Q

most common level of aortic stenosis?

A

aortic valve

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21
Q

Early sxs of aortic stenosis

A

DOE

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22
Q

does early aortic stenosis present with chest pain?

A

no

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23
Q

late sxs of aortic stenosis

A

angina

syncope

heart failure

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24
Q

how often should repeat echo be performed in mild, moderate, and severe asymptomatic valve issues?

A

mild: 3-5 years, monitor sxs development
moderate: 1-2 years

severeL every 6-12 months, include cards

25
Q

symptomatic aortic stenosis is treated with…

A

referral to CT surg or interventional cards

26
Q

which type of prosthetic valve requires anticoagulation?

A

mechanical

27
Q

which type of prosthetic valve lasts longer?

A

mechanical

28
Q

HCM presents with the same murmur as AS, but is enhanced with…

A

standing

valsalva

29
Q

MC cause of chronic aortic regurg…

A

aortic root dilation

30
Q

MC valve disease causing chronic aortic regurg…

A

calcification

31
Q

MC aortic regurg cause that occurs with valve disease and aortic root dilation…

A

bicuspid aortic valve

32
Q

Acute aortic regurgitation presents with…

A

profound hypotension

cardiogenic shock

pulmonary edema

s/s of endocarditis/aortic dissection

33
Q

chronic aortic regurgitation results in what physical manifestations on the heart?

A

gradual dilation and eccentric hypertrophy

34
Q

wide pulse pressure

corrigan pulse

austin-flint murmur

these are physical exam findings indicative of…

A

aortic regurgitation

35
Q

chronic aortic regurgitation presents with what findings on CXR?

A

LVH

Cardiomegaly

36
Q

how is acute aortic regurg managed

A

emergent valve surgery

37
Q

how is symptomatic chronic aortic regurgitation managed?

A

refer to CT surg or interventional cards

38
Q

what is a common cause of chronic mitral regurgitation

A

connective tissue disorders

39
Q

acute mitral regurgitation can be ischemic or non-ischemic.

ischemic causes include…

A

papillary muscle damage

40
Q

acute mitral regurgitation can be ischemic or non-ischemic.

non-ischemic include

A

ruptured chordae tendineae

MVP, endocarditis, trauma, ARF

41
Q

acute mitral regurgitation will present with…

A

very ill

pulmonary edema

hypotension

shock

42
Q

chronic mitral regurgitation will present with…

A

heart failure sxs

pulmonary HTN

LAE, RVH

43
Q

acute mitral regurgitation is manged with…

A

IV nitroprusside and urgent surgical consult

44
Q

chronic nonischemic mitral regurgitation is managed medically for HTN, hypervolemia, and a.fib with..

A

HTN: ACE-I, vasodilators

hypervolemia: na restriction, diuretics
a. fib: warfarin with 2-3 INR, digoxin

45
Q

Mitral valve prolapse is often asymptomatic, but can also present with…

A

atypical or non-anginal chest pain

46
Q

what tx can be offered for mitral valve prolapse with palpitation or arrhythmia

A

beta blockers

47
Q

what is the most common cause of mitral stenosis?

A

rheumatic heart disease

48
Q

What can cause sxs in mitral stenosis?

A

exertion, excitement

fever

anemia

pregnancy

a. fib

49
Q

what sxs are common with mitral stenosis?

A

sxs of LHF and RHF

hemoptysis

50
Q

What can manage mild mitral stenosis?

A

diuretics and sodium restriction

51
Q

if mitral stenosis occurs with afib, hx of emboli, or significant LAE, what tx should be offered?

A

warfarin (INR 2-3)

52
Q

For progressing sxs of mitral stenosis, what can be done?

A

valve surgery

53
Q

Generally, valvular stenosis is not a ______ process

A

not acute

54
Q

Generally, valvular regurgitation can present as a ______ process

A

acute

55
Q

What is the main tx goal for afib?

A

prevention of systemic embolization

56
Q

what can be prescribed for patients with afib and a mechanical heart valve?

A

warfarin

57
Q

what is included in rhythm control strategy for afib…

A

antiarrhythmic meds

ablation

surgery

58
Q

what is included in a rate control strategy for afib?

A

beta blockers

non-dihydropyridine CCB

digoxin

Clinical Medicine II (31 decks)

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