CBL - Aortic Stenosis Flashcards
What is the function of the mitral valve? [1]
Controls blood flow into the left ventricle (LV) from the left atrium (LA)
What prevents the mitral valve from prolapsing into the left atrium? [2]
- chordae tendineae
- papillary muscles
When does the mitral valve open? [1]
when left atrial pressure exceeds left ventricular pressure during diastole, when LV pressures are low because of ventricular muscle relaxation
What is the function of the tricuspid valve? [1]
controls blood between the right atrium (RA) and the right ventricle (RV)
What is the function of the aortic valve? [1]
controls blood flow from LV into the aorta
When does the aortic valve open? [1]
when the systolic pressure in the LV exceeds the end-diastolic pressure in the aorta e.g. 80 mmHg and closes when the pressure falls towards the end of systole
What is the function of the pulmonary valve? [1]
controls blood flow between the right ventricle (RV) and the pulmonary artery (PA)
Label the following diagram representing the normal pressure/flow relationships for the left side of the heart [9]
- diastole
- systole
- diastole
- mitral valve closes
- aortic valve opens
- aortic valve closes
- mitral valve opens
- S1
- S2
Define a heart murmur [1]
a sound produced by turbulent blood flow
Stenosis of a valve produces turbulent flow during a period of the cardiac cycle when blood does not normally flow across the valve/passes through it in the correct direction
(choose an option)
Stenosis, or narrowing, of a valve produces turbulent flow when blood passes through it in the correct direction
Regurgitation through a valve produces turbulent flow during a period of the cardiac cycle when blood does not normally flow across the valve/passes through it in the correct direction
(choose an option)
Regurgitation through the valve (also called incompetence) produces turbulence during a period of the cardiac cycle when blood does not normally flow across the valve
What does an aortic stenosis murmur sound like and when does it occur (systolic/diastolic etc)? [2]
low pitched ejection systolic murmur
Where is an aortic stenosis murmur best heard? [1]
best heard in the aortic area
Where does an aortic stenosis murmur tend to radiate to? [1]
radiate to the neck
What does an aortic regurgitation murmur sound like and when does it occur (systolic/diastolic etc)? [2]
high-pitched (blowing) early diastolic murmur
Where is an aortic regurgitation murmur best heard? [2]
best heard at the left sternal edge with patient sitting forward in expiration
What does a mitral stenosis murmur sound like and when does it occur (systolic/diastolic etc)? [2]
low-pitched (rumbling) mid-diastolic murmur
Where is a mitral stenosis murmur best heard? [2]
best heard at the apex with patient lying on their left side
What does a mitral regurgitation murmur sound like and when does it occur (systolic/diastolic etc)? [2]
high-pitched (blowing) pan-systolic murmur
Where is a mitral regurgitation murmur best heard? [1]
best heard at the apex
Where does a mitral regurgitation murmur tend to radiate to? [1]
tends to radiate to the axilla
Where is a tricuspid stenosis murmur best heard and when does it occur (systolic/diastolic etc)? [2]
distolic murmur at left sternal edge
(rare)
What does a pulmonary stenosis murmur sound like, when does it occur (systolic/diastolic etc) and where can it be found? [3]
soft ejection murmur in the pulmonary area
What does a pulmonary regurgitation murmur sound like, when does it occur (systolic/diastolic etc) and where can it be found? [3]
soft early diastolic murmur in pulmonary area
When does a murmur caused by ventricular septal defect occur (systolic/diastolic etc)? [1]
pan-systolic murmur
What are the typical examination findings of aortic stenosis? [4]
- ejection systolic murmur,
- an associated thrill (palpable murmur),
- a slow-rising (“plateau”) pulse, with reduced pulse pressure
- a forceful apex beat
What are the typical examination findings in aortic regurgitation? [3]
- early diastolic murmur
- large volume “collapsing” pulse, with large pulse pressure
- displaced apex beat
What investigations are used for aortic valve lesions? [6]
- ECG
- Chest X-ray
- Echocardiography
- Doppler Echo
- Exercise testing
- Coronary angiography
What are the management options for aortic valve lesions? [3]
- surgical valve replacement
- percutaneous valve replacement (given to people who are too ill to survive surgery)
- transcutaneous aortic valve implantation (TAVI)
