CV - aortic and pulmonic valve disease

Question 1

aortic valve is a __________ valve.

Answer 1

trileaflet

Question 2

the __________ is the most common congenital cardiac malformation.

Answer 2

bicuspid aortic valve

Question 3

what are the sequelae of the bicuspid aortic valve?

Answer 3

aortic stenosis
aortic insufficiency
aortic dilatation
endocarditis

Question 4

there are two subtypes of the bicuspid aortic valve, the __________ and the __________.

Answer 4

true bicusp

functional bicusp

Question 5

the complications of a bicuspid aortic valve are defined under what two categories?

Answer 5

valvular complications

vascular complications

Question 6

what are the valvular complications of a bicuspid aortic valve?

Answer 6

aortic stenosis
aortic insufficiency due to cusp prolapse
endocardidis

Question 7

what are the vascular complications of a bicuspid aortic valve?

Answer 7

aortic dilation
aneurysm formation
aortic dissection

Question 8

what is heard during auscultation of a bicuspid aortic valve?

Answer 8

???

Question 9

what is the management?

Answer 9

monitoring for progression of disease to aortic stenosis or aortic insufficiency
aortic screening - size
family screening

Question 10

key points - bicuspid aortic valve

Answer 10

bicuspid aortic valve is the most common congenital cardiac defect
often familial, first degree relatives should be screened
complications are aortic stenosis, aortic insufficiency, endocarditis
associated with dilation of the proximal ascending aorta

Question 11

what are the three etiologies of aortic stenosis?

Answer 11

congenital - bicuspid
calcific - most common, occurs in the elderly
rheumatic - occurs along with mitral valve disease

Question 12

symptoms of aortic stenosis

Answer 12

dyspnea on exertion
exertional lightheadedness or syncope
exertional angina

Question 13

more severe aortic stenosis disease is associated with:

Answer 13

mid- to late-peaking murmur
soft second heart sound (S2 soft)
slow rate of rise in the carotid pulse

Question 14

treatment of aortic stenosis

Answer 14

medical therapy

aortic valve intervention

Question 15

key points - aortic stenosis

Answer 15

most common etiologies include calcific disease and bicuspid valve
harsh systolic murmur at right upper sternal border, radiation to carotids
symptoms angina, congestive heart failure, syncope

Question 16

describe aortic insufficiency

Answer 16

insufficient valve closure such that blood flows backwards from aorta during diastole, leading to increased volume load and left ventricle dilation, systolic dysfunction, heart failure

Question 17

etiologies of aortic insufficiency are divided into what two categories?

Answer 17

valve disease

aortic disease

Question 18

what are the physical exam findings associated with aortic insufficiency?

Answer 18

"water hammer" pulse
deMusset's sign
Quincke's pulses
Mueller's sign
Corrigan's sign

Question 19

what is the Austin-Flint murmur?

Answer 19

diastolic murmur at the apex

secondary to turbulent diastolic blood flow across the mitral valve

Question 20

key points - pulmonic insufficiency

Answer 20

mild-moderate PI is a common finding in normal hearts, does not warrant intervention unless it progresses to symptomatic disease