Cardiovascular

Question 1

Causes of aortic regurgitation

Answer 1

Acute
* Aortic dissectio
* Infective endocarditis
* Rheumatic fever

Chronic
* Bicuspid aortic valve
* Marfan’s
* Ankylosing spondylitis & seronegative arthritides

AIR (acute) | BMA (chronic)

Question 2

Indications for valve surgery in aortic regurgitation

Answer 2

• Acute and severe
• Chronic and symptomatic
• Asymptomatic → aortic root dilatation, LV dilatation & LVEF < 50%

Question 3

Causes of aortic stenosis

Answer 3

Common
* Degenerative calcification
* Bicuspid valve

Rare
* Congenital
* Hyperuricaemia (Gout)
* Infective endocarditis
* Rheumatic fever
* Paget’s disease

CHIRP (rare)

Question 4

Indications for valve surgery in aortic stenosis

Answer 4

Symptomatic and EF < 50%:
* Mean gradient > 40 mmHg
* Aortic valve area < 1 cm2
Asymptomatic:
* Peak aortic jet velocity > 5m/s
* LVEF < 55%

Question 5

Cardiac causes of clubbing

Answer 5

• Cyanotic congenital heart disease
• Infective endocarditis
• Atrial myxoma

CIA

Question 6

Congenital heart disease

Answer 6

Cyanotic:
* Tetralogy of Fallot
* Transposition of the great vessels
* Pulmonary or tricuspid stenosis
* Pulmonary or tricuspid atresia
* Ebstein’s anomoloy

Acyanotic:
* Aortic stenosis
* Coarctation of the aorta
* Uncomplicated VSD / ASD / PSA

Question 7

Causes of mitral regurgitation

Answer 7

• Cardiomyopathy
• Connective tissue disease
• Infective endocarditis
• Post-MI
• Rheumatic fever
• Autoimmune (Rheumatoid arthritis / Libman-Sachs endocarditis in SLE)
• Mitral valve prolapse
• Degenerative

Question 8

Causes of mitral stenosis

Answer 8

• Rheumatic fever
• Atrial myxoma
• Congenital
• Degenerative
• Infective endocarditis

ACDE

Question 9

Causes of pulmonary stenosis

Answer 9

• Congenital rubella
• Rheumatic fever
• Tetralogy of Fallot
• Carcinoid syndrome

RCT

Question 10

Causes of pulmonary regurgitation

Answer 10

• Surgery → correction of Tetralogy of Fallot
• Carcinoid
• Congenital absence of pulmonary valve
• Rheumatic fever
• Infective endocarditis
• Marfan’s syndrome
• Pulmonary hypertension

SCRIMP

Question 11

Causes of tricuspid stenosis

Answer 11

• Rheumatic fever
• Carcinoid syndrome

Question 12

Causes of tricuspid regurgitation

Answer 12

• Pulmonary hypertension
• Rheumatic fever
• Infective endocarditis
• Carcinoid syndrome
• Ebstein’s anomaly