Exam 1 - valvular disorders Flashcards
what are symptoms of mitral stenosis
pulm htn + hemoptysis
afib* from dilated vessels
SOB at rest
flushed cheeks
R sided HF (late finding)
which murmur has a harsh midsystolic ejection crescendo-decrescendo murmur that increases with inspiration?
pulmonic stenosis
which murmur radiates to the carotids, where you feel a more sustained impulse?
aortic stenosis
3 common symptoms of aortic stenosis?
angina*
syncope
CHF
What may happen as a result of the gradient in aortic stenosis?
severe LVH - LV may fail
CO is fixed
02 needs increase
decreased coronary blood flow
what causes PS?
almost always congenital
seen in young pts
which murmur has a mid-diastolic rumble at the L 4th ICS that increases intensity with venous return, and an opening snap?
tricuspid stenosis
what can mvp potentially lead to?
stroke, endocarditis, PVCs
what type of a gradient is caused by aortic stenosis, and where?
systolic gradient between LV and aorta
what are the symptoms of mvp?
most are asx
atypical/fleeting chest pain, panic attacks, arrhythmias, fatigue, palpitations, dizziness
what is the MC cause of mitral stenosis
rheumatic heart disease
which murmur radiates to the neck?
PS
what is the patho of mitral stenosis
obstructed flow from LA to LV
leads to LAE, inc LA pressure, pulm HTN
when would you hear a systolic ejection click that increases with expiration?
HF
what is the tx for mitral stenosis?
rate control
valvotomy
*percutaneous balloon valvuloplasty
What causes aortic stenosis?
degeneration
congenital
How do you treat aortic stenosis?
aortic valve replacement
fully anticoag forever
which murmur has a prominent S1 closing snap, and an opening snap after S2
mitral stenosis
what is the tx for mvp?
reassurance of a good prognosis
could use beta blockers
could do MV repair
which murmur has a pulse of reduced intensity?
mitral stenosis
Which murmur has a split S2 and an S4 sound?
aortic stenosis
how do you diagnose murmurs other than PE?
ECG
Echo/Doppler
CXR for late findings
what is the tx of PS?
balloon valvuloplasty
Which murmur gives you a LV heave and a laterally deplaced apex?
aortic stenosis
what is the patho of pulmonic stenosis?
obstruction of blood flow from R ventricle to pulmonic valve
how do you tx TS?
medical: decrease RA overload with diuretics and decreased salt
surgical: commisurotomy or TV replacement
What is the patho of aortic stenosis?
the aortic valve narrows
this prevents the valve from opening fully, and thus obstructs blood going from the ventricle —> aorta —> body
what is the patho of tricuspid stenosis
blood backs up into the RA
leads to RAE, leads to R sided failure
which murmur is assoc with young women and CT disease
mvp
what causes tricuspid stenosis?
carcinoid heart dz, rheumatic heart dz
what is the patho of mvp?
mitral valves are floppy
they buckle and are leaky
which murmur is assoc with a thin pt with narrow AP diameter, and hypotension?
mvp
which murmur has a midsystolic ejection click at the apex and a longer duration?
mvp
which murmur has a systolic ejection click with a crescendo-decrescendo
Grade 2-4
is harsh, low-pitched
aortic stenosis
