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Y1 Cardiovascular > Conditions - Valvular diseases > Flashcards

Conditions - Valvular diseases Flashcards

1
Q

What is aortic stenosis

A

Narrowing of aortic valve

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2
Q

What are the possible consequences of aortic stenosis

A

Harder to pump blood to the body -> Left ventricular hypertrophy -> heart failure/cardiogenic shock

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3
Q

What are the causes of aortic stenosis

A

Aging
Post rheumatic fever
Congenital

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4
Q

What are the common symptoms of valvular diseases

A

Dyspnea
Presyncope
Syncope
Chest pain

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5
Q

List the clinical signs of aortic stenosis

A 
Low volume pulse 
Displaced apex 
Soft S2
Narrow pulse pressure
4th heart sound
Ejection systolic murmur
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6
Q

What causes displaced apex beat

A

Left ventricular hypertrophy

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7
Q

Treatment of aortic stenosis

A 
If asymptomatic - observe
If symptomatic 
- Valvular replacement 
- Trans catheter aortic valve replacement
- Balloom aortic valvotomy
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8
Q

What is balloon aortic valvotomy

A

the stenotic leaflets are forced apart

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9
Q

What is mitral regurgitation

A

Leaky mitral valve, causing blood to flow back into left atria, decreasing CO and may cause blood to back up in lungs

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10
Q

What are the causes of mitral regurgitation

A 
Acute endocarditis 
Acute rupture of papillary muscle / chordae 
Post MI 
Aging 
Rheumatic fever
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11
Q

What can mitral regurgitation cause

A

Left heart failure - pulmonary congestion and systemic hypoperfusion

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12
Q

Clinical signs of mitral regurgitation

A

Displaced apex beat
Pansystolic murmur
Split S2
Third heart sound

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13
Q

How to identify left ventricular hypertrophy on ECG

A

lead I most positive

lead 2 and 3 negative

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14
Q

What are the treatments for mitral regurgitation

A

Diuretics + ACEi + beta blockers for HF

surgical repair or replacement

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15
Q

What is aortic regurgitation

A

Leaky aortic valve, causing blood to flow back into left ventricle, decreasing CO and may cause left HF

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16
Q

What are the causes of aortic regurgitation

A

Endocarditis
Rheumatic fever
Marfan’s syndrome
Aortic dissection

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17
Q

What are the clinical signs of aortic regurgitation

A

Displaced apex
Collapsing pulse
Early diastolic murmur
wide pulse pressure

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18
Q

Where is the early diastolic murmur of aortic regurgitation heard

A

At left sternal edge

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19
Q

When is balloon valvuloplasty used

A

When valvular replacement is not suitable

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20
Q

What causes mitral stenosis

A

Rheumatic fever

Congenital

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21
Q

What is the main reason for aortic stenosis

A

Aging

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22
Q

What is the main reason for mitral stenosis

A

Rheumatic fever

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23
Q

What are the clinical signs for mitral stenosis

A

Tapping apex beat
Mid diastolic murmur
Loud S1

24
Q

What is mitral stenosis most commonly associated to

A

Atrial fibrillation

25
Q

What are the ECG findings of AF

A

rapid, narrow QRS
irregularly irregular
absent of discrete p waves - the p waves are very irregular

26
Q

What is the murmur heard in aortic stenosis

A

Ejection systolic murmur

27
Q

What is the murmur heard in Aortic regurgitation

A

Early diastolic murmur

28
Q

What is the murmur heard in mitral stenosis

A

Mid diastolic murmur

29
Q

What is the murmur heard in mitral regurgitation

A

Pansystolic murmur

30
Q

Which pathogen is the most common cause of infective endocarditis

A

Staphylococcus aureus

31
Q

Which pathogen is the most common cause of prosthetic IE

A

Staphylococcus epidermis

32
Q

What type of staphylococci is staph. epidermis

A

Coagulase negative

33
Q

How does the range of possible pathogen change in prosthetic IE

A

First 2 months - most commonly staph. epidermis or other coagulase negative staph.

After 2 months - staphylococcus aureus

34
Q

Which pathogen is most associated to poor dental hygiene

A

Streptococcus viridans

35
Q

What is the feature of streptococcus bovis

A

Associated w colorectal cancer

36
Q

What are the risk factors for IE

A 
Age 
Male
IV drug users 
Previous IE
Prosthetic heart valves
IV lines
poor dental hygiene
37
Q

Which valve is most commonly affected in native IE

A

Mitral valve

38
Q

Which valve does IE caused by IV drug use affect

A

Tricuspid valve

39
Q

Which pathogen is most common in IV drug users

A

Staphylococcus aureus

40
Q

What are the symptoms of IE

A 
Fever
Malaise
Dyspnea
Chest pain
Splinter haemorrhage
41
Q

What can IE cause

A

Embolism (septic embolism)
Damaged valves
HF due to damaged valves
valvular diseases

42
Q

What are the clinical signs of septic embolism

A

Roth spots - eye
Janeway lesions - hand and feet
Renal / splenic / pulmonary abscesses

43
Q

What is a possible ECG finding of IE

A

Prolonged PR interval

44
Q

Why may a prolonged PR interval be present in IE

A

If the infection is at aortic root

45
Q

How to diagnose IE

A

3 sets of blood tests
ECG
Echocardiogram

46
Q

What does echocardiogram look at

A

Presence of vegetation or abscesses
Valvular function
Ejection fraction
abnormal blood flow through prosthetic valve

47
Q

What types of echocardiogram are used for IE investigation

A

Transthoracic first then transesophageal if transthoracic is negative but there is high suspicion

48
Q

What is the treatment for IE caused by staphylococcus aureus

A

Flucloxacillin

Gentamicin + vancomycin if MRSA

49
Q

What are the antibiotics used against Staph. epidermis

A

Vancomycin + gentamicin + rifampicin

50
Q

What antibiotics are used against Streptococcus viridans

A

Benzylpenicillin + gentamicin

51
Q

Gentamin is a narrow / broad spectrum antibiotic

A

broad spectrum

52
Q

Which part of heart infarction is commonly associated with mitral regurgitation

A

Inferior / posterior

53
Q

Which 2 valves are most prone to dysfunction after heart failure

A

Mitral regurgitation and tricuspid regurgitation

54
Q

What would a patient with infective endocarditis usually show

A

Murmur

Recurrent fever

55
Q

What is the most common cause of aortic regurgitation

A

Aortic dissection

Y1 Cardiovascular (6 decks)

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