CVM Flashcards
MITRAL STENOSIS
- SEVERITY
- TX
<1CM2 ; EARLY OPENING SNAP ; PHTN ; CCF
MVR IF CCF, PHTN, HEMOPTYSIS, RECURRENT VTE DESPITE ANTICOAGULATION
- VALVULOPLASTY IF MOBILE I.E. LOUD S1 + OPENING SNAP ; MIN CALCIFICATION ; NO MR ; NO LA THROMBUS
MITRAL REGURG
- SEVERITY
- TX
SOFT S1 ; S3 ; PHTN ; CCF
MVR IF CCF ; ASX+EF<60 OR LVESD>45
S3 from rapid ventricular filling in early diastole
AORTIC REGURG
- SEVERITY
- TX
WIDE PULSE PRESSURE ; LONGER MURMUR ; SOFT S2 ; S3 ; CCF
AVR IF SX(ANGINA/CCF); ASX+EF<50 OR LVESD>55 OR LVEDD>75 ; AORTIC ROOT >50MM
AUSTIN FLINT MURMUR - FUNCTIONAL MS 2’ AR
AORTIC STENOSIS
- SEVERITY
- TX
NARROW PULSE PRESSURE ; SOFT S2 ; REVERSE SPLIT S2 ; S4 ; CCF
AVR IF SX ; ASX+HIGH GRADIENT >50MMHG+EITHER OF THE FOLLOWING: EF<50 ; LVH ; VT; AVA <0.6CM2 ; ASX+CABG
S4 vigorous atrial contraction in late diastole
INFECTIVE ENDOCARDITIS
- DUKE CRITERIA
- INDICATIONS FOR SURGERY
- IE PROPHYLAXIS
2MAJOR ; 1MAJOR+3MINOR ; 5MINOR
2 SETS BC+ 12H APART ; ECHO ; T>38 ; RISKFACTORS E.G. IVDA ; IMMUNO/EMBOLIC SIGNS INCL. GLOMERULONEPHRITIS
ABSCESS ; FISTULA ; HEART BLOCK ; CCF ; BC+ DESPITE 7D ABX ; MDRO/FUNGAL
PROSTHETIC CARDIAC MATERIALS/VALVES ; CARDIAC TRANSPLANT ; RECURRENT IE UNDERGOING DENTAL / RESPI PROCEDURES THAT INVOLVE DAMAGING OF MUCOSA
VSD
- ETIOLOGY
- SYNDROMES
- INDICATIONS FOR SURGERY
CONGENTIAL ; AMI
TOF ; AVSD ; PDA ; TRUNCUS ARTERIOSUS / TGA / PULMONARY ATRESIA OR STENOSIS
RISK OF DEVELOPING PHTN IN PREGNANCY
IN ADULTS, EITHER VSD IS SMALL OR THE PATIENT HAS ALREADY DEVELOPED EISENMENGER SYNDROME
THOSE WHO HAVE YET WILL BENEFIT FROM SURGERY IF: SIGNIFICANT SHUNT ; RECURRENT IE ; WORSENING AR 2’ CUSP PROLAPSE THROUGH VSD ; ACUTE VSD 2’ SEPTAL RUPTURE
DO NOT CLOSE IN EISENMENGER SYNDROME -> defect acts as an outlet for the RV to pump into the systemic circulation and maintain cardiac output at the cost of arterial desaturation
ASD
- SYMPTOMS/SIGNS/COMPLICATIONS
- SYNDROMES
- INDICATIONS FOR SURGERY
ESM+WIDE FIXED SPLIT S2
- CHEST PAIN / DYSPNEA / PALPITATIONS / HEARTBLOCK / CHEST INFECTIONS
- COMPLICATIONS OF AF / IE / CCF / PHTN / PARADOXICAL EMBOLI / EISENMENGER SYNDROME
- RISK OF DEVELOPING PHTN IN PREGNANCY
- ECG: RBBB + RAD (SECUNDUM) OR LAD (PRIMUM)
LUTEMBACHER SYNDROME - ASD+ACQUIRED RHEUMATIC MS ; HOLT-ORAM SYNDROME (hypoplastic thumb+accessory phalanx)
SURGERY IF: SIGNIFICANT SHUNT ; PHTN ; PARADOXICAL EMBOLI
HOCM
- COMPLICATIONS
- SYNDROME
- SCD ; AF ; IE ; STROKE
- WPW / FRIEDERICH ATAXIA ; MITRAL REGURG
- AVOID DIGOXIN / VASODILATOR AS THEY WORSEN OUTFLOW OBSTRUCTION
- MEDICAL: BB / CCB / AMIODARONE ; MYOMECTOMY ; ICD
PDA
- FEATURES
- COMPLICATIONS
COLLAPSING PULSE ; LSCF CONTINUOUS MURMUR W THRILL
PHTN ; IE ; CCF ; ENDARTERITIS ; INFANTS: NEC, BRONCHOPULMONARY DYSPLASIA ; DEATH
FOR ALL SHUNTS; COMMENT ON HEMODYNAMIC SIGNIFICANCE -> PHTN W LVH
PULMONARY STENOSIS
- FEATURES
ESM AT ERB’S POINT THAT DECREASES W INSPIRATION
CLUBBING + CYANOSIS
NOONAN SYNDROME ; WILLIAMS SYNDROME
COARCTATION OF AORTA
- FEATURES
- COMPLICATIONS
- SYNDROMES
- other causes of absent radial pulse
- other causes of RF delay
ESM @ LSTERNAL BORDER/BACK + ESM (BICUSPID AORTIC VALVE) + RF DELAY + L CAD, STROKE, ICH, LVF, AORTA RUPTURE ; ICH ; ENDARTERITIS
TURNER SYNDROME , BERRY ANEURYSMS
EISEMENGER syndrome
- FEATURES
- onset
- COMPLICATIONS
clubbing+cyanosis ; loud/palpable P2+parasternal heave + TR and giant CV wave
VSD/ASD/PDA
infancy for VSD/PDA ; adulthood for ASD
IE ; PARADOXICAL EMBOLI/STROKE ; HEMOPTYSIS ; BRAIN ABSCESS ; ERYTHROCYTOSIS/HYPERVISCOSITY
TETRALOGY OF FALLOT
- FEATURES
clubing, cyanosis ; thoracotomy scar (BTS) + L
