Heart Valve Disease Flashcards
Aortic and Mitral Regurg when to operate?
early
which valves you replace early?
mitral and aortic regurg
when give antibiotics for dental work/endocarditis prophylaxis?
only ppl with prosthetic valves
what are you trying to figure out for timing and valve disease
when to do the surgery
rheumatic fever cause?
Group A beta hemolytic/Strep pyogenes
diagnostic test for Rheumatic fever?
Nope. Scored on clinical features. Jones’ criteria. Sydenham’s chorea
Mitral stenosis is usually only due to?
Rheumatic Fever
can be sub-clinical: so if can’t give history: not reliable
rheumatic fever treatment?
long term antibiotics prophylaxis
what colour on echo when blood moving towards vs. away
towards: blue
away: red
TOE particularly good for what 3 things?
mitral valve
left atrium thrombi detection
endocarditis: vegetations on pacemaker leads
LV compensation to regurg mitral/aortic
- increase stroke volume
- increase ejection fraction
what happens in severe regurg left ventricle?
irreversible deterioration
- too much EDV,
- increase ESV
- decrease ejection fraction
when do you get symptoms of aortic regurg?
when it’s severe regurg.
when do surgery for regurg?
early. follow closely with echo
what kind of hypertrophy in regurg
eccentric hypertrophy
what kind of hypertrophy in stenosis?
concentric hypertrophy
Normal ejection fraction?
50%
70ml
most common valve lesion?
calcific aortic lesion in ppl aged 70-80s
aortic stenosis symptoms?
SAD, only when severe
syncope
angina
dyspnoea
best place to hear aortic stenosis?
upper right sternal edge with diaphragm
where can you hear severe aortic stenosis?
base and apex
when do aortic stenosis replacement?
usually not until symptoms
(S)tenosis - Symptoms
causes of aortic regurg? re: valves, roots
valves: endocarditis, Rheum. Fever
root: Marfans, dissection, syphilis
decribe aortic regurg pulse pressure?
wide pulse pressure?
what kind of pulse in aortic regurg?
water-hammer pulse/collapsing pulse
aortic regurg sound?
after S2 - collapse: in diastole
causes of mitral regurg
myxomatous degen
mitral valve prolapse
cause of sudden mitral regurg?
ruptured chordae tendinae
mitral regurg murmur sound?
pan-systolic: same intensity throughout, finishes after S2
mitral stenosis sound?
diastolic rumbling murmur
mitral stenosis affects what?
left atrium due to pressure overload
-AF
tricuspid regurg cause?
right ventricular failure from pulmonary hypertension
