Exam 1 - valvular disorders

Question 1

what are symptoms of mitral stenosis

Answer 1

pulm htn + hemoptysis

afib* from dilated vessels

SOB at rest

flushed cheeks

R sided HF (late finding)

Question 2

which murmur has a harsh midsystolic ejection crescendo-decrescendo murmur that increases with inspiration?

Answer 2

pulmonic stenosis

Question 3

which murmur radiates to the carotids, where you feel a more sustained impulse?

Answer 3

aortic stenosis

Question 4

3 common symptoms of aortic stenosis?

Answer 4

angina*

syncope

CHF

Question 5

What may happen as a result of the gradient in aortic stenosis?

Answer 5

severe LVH - LV may fail

CO is fixed

02 needs increase

decreased coronary blood flow

Question 6

what causes PS?

Answer 6

almost always congenital

seen in young pts

Question 7

which murmur has a mid-diastolic rumble at the L 4th ICS that increases intensity with venous return, and an opening snap?

Answer 7

tricuspid stenosis

Question 8

what can mvp potentially lead to?

Answer 8

stroke, endocarditis, PVCs

Question 9

what type of a gradient is caused by aortic stenosis, and where?

Answer 9

systolic gradient between LV and aorta

Question 10

what are the symptoms of mvp?

Answer 10

most are asx

atypical/fleeting chest pain, panic attacks, arrhythmias, fatigue, palpitations, dizziness

Question 11

what is the MC cause of mitral stenosis

Answer 11

rheumatic heart disease

Question 12

which murmur radiates to the neck?

Answer 12

PS

Question 13

what is the patho of mitral stenosis

Answer 13

obstructed flow from LA to LV

leads to LAE, inc LA pressure, pulm HTN

Question 14

when would you hear a systolic ejection click that increases with expiration?

Answer 14

HF

Question 15

what is the tx for mitral stenosis?

Answer 15

rate control

valvotomy

*percutaneous balloon valvuloplasty

Question 16

What causes aortic stenosis?

Answer 16

degeneration

congenital

Question 17

How do you treat aortic stenosis?

Answer 17

aortic valve replacement

fully anticoag forever

Question 18

which murmur has a prominent S1 closing snap, and an opening snap after S2

Answer 18

mitral stenosis

Question 19

what is the tx for mvp?

Answer 19

reassurance of a good prognosis

could use beta blockers

could do MV repair

Question 20

which murmur has a pulse of reduced intensity?

Answer 20

mitral stenosis

Question 21

Which murmur has a split S2 and an S4 sound?

Answer 21

aortic stenosis

Question 22

how do you diagnose murmurs other than PE?

Answer 22

ECG

Echo/Doppler

CXR for late findings

Question 23

what is the tx of PS?

Answer 23

balloon valvuloplasty

Question 24

Which murmur gives you a LV heave and a laterally deplaced apex?

Answer 24

aortic stenosis

Question 25

what is the patho of pulmonic stenosis?

Answer 25

obstruction of blood flow from R ventricle to pulmonic valve

Question 26

how do you tx TS?

Answer 26

medical: decrease RA overload with diuretics and decreased salt surgical: commisurotomy or TV replacement

Question 27

What is the patho of aortic stenosis?

Answer 27

the aortic valve narrows this prevents the valve from opening fully, and thus obstructs blood going from the ventricle ---\> aorta ---\> body

Question 28

what is the patho of tricuspid stenosis

Answer 28

blood backs up into the RA leads to RAE, leads to R sided failure

Question 29

which murmur is assoc with young women and CT disease

Answer 29

mvp

Question 30

what causes tricuspid stenosis?

Answer 30

carcinoid heart dz, rheumatic heart dz

Question 31

what is the patho of mvp?

Answer 31

mitral valves are floppy they buckle and are leaky

Question 32

which murmur is assoc with a thin pt with narrow AP diameter, and hypotension?

Answer 32

mvp

Question 33

which murmur has a **midsystolic ejection click** at the apex and a longer duration?

Answer 33

mvp

Question 34

which murmur has a systolic ejection click with a **crescendo-decrescendo** Grade 2-4 is harsh, low-pitched

Answer 34

aortic stenosis