Cardiovascular- Valvular disease Flashcards
Holosystolic murmur at left lower sternal border
Tricuspid regurgitation
Mechanism of tricuspid regurgitation (TR)
90% secondary TR.
RV cavity enlargement–> annular dilation & ↑tension chord tendineae –> inadequate closure.
Primary TR: chordae tendineae rupture (myxomatous degeneration)
Symptoms of primary vs secondary TR
Both have right sided HF but differ in onset.
Primary: acute TR = rapid onset
Secondary: Progressive
Holosystolic murmur at the cardiac apex
Mitral regurgitation
Radiates to axila
Decrescendo early diastolic murmur beast heard at the left sternal border
Aortic regurgitation (valvular in nature)
Heard better while leaning forward and holding expiration
Decrescendo Early diastolic murmur beast heard at the right upper sternal boarder
Aortic regurgitation with root dilation
S&S of aortic regurgitation
Palpitations Chest pain Dyspnea Widened pule pressure Water- hammer pulse (rapid rise& fall) Abrupt carotid distention & collapse
Bicuspid aortic valve (BAV)
Congenital heart disease (some sporadic cases).
Causes AS (50s-60s), AR (30s-40s), or AR w/ root dilation (aneurysm, dissection, sudden death).
Harsh crescendo-decrescendo systolic murmur best heard at left sternal border
Hypertrophy cardiomyopathy
Increased with ↓preload
Diagnosis: 30yo male, palpitations, FHx sudden death @ 40, decrescendo early diastolic murmur.
Bicuspid aortic valve
Family history Ddx: BAV or HCM. Symptoms of aortic regurgitation indicate BAV
Causes of aortic regurgitation
Congenital bicuspid valve
Postinflamatory (RF, endocarditis)
Aortic root dilation (marfan, syphilis, BAV)
High-pitch sound after S1 best heard during expiration followed by a crescendo-decrescendo systolic murmur over the left second intercostal space.
pulmonic valve stenosis
