Heart Valve Disease

Question 1

Aortic and Mitral Regurg when to operate?

Answer 1

early

Question 2

which valves you replace early?

Answer 2

mitral and aortic regurg

Question 3

when give antibiotics for dental work/endocarditis prophylaxis?

Answer 3

only ppl with prosthetic valves

Question 4

what are you trying to figure out for timing and valve disease

Answer 4

when to do the surgery

Question 5

rheumatic fever cause?

Answer 5

Group A beta hemolytic/Strep pyogenes

Question 6

diagnostic test for Rheumatic fever?

Answer 6

Nope. Scored on clinical features. Jones’ criteria. Sydenham’s chorea

Question 7

Mitral stenosis is usually only due to?

Answer 7

Rheumatic Fever

can be sub-clinical: so if can’t give history: not reliable

Question 8

rheumatic fever treatment?

Answer 8

long term antibiotics prophylaxis

Question 9

what colour on echo when blood moving towards vs. away

Answer 9

towards: blue
away: red

Question 10

TOE particularly good for what 3 things?

Answer 10

mitral valve
left atrium thrombi detection
endocarditis: vegetations on pacemaker leads

Question 11

LV compensation to regurg mitral/aortic

Answer 11

• increase stroke volume

- increase ejection fraction

Question 12

what happens in severe regurg left ventricle?

Answer 12

irreversible deterioration

• too much EDV,
• increase ESV
• decrease ejection fraction

Question 13

when do you get symptoms of aortic regurg?

Answer 13

when it’s severe regurg.

Question 14

when do surgery for regurg?

Answer 14

early. follow closely with echo

Question 15

what kind of hypertrophy in regurg

Answer 15

eccentric hypertrophy

Question 16

what kind of hypertrophy in stenosis?

Answer 16

concentric hypertrophy

Question 17

Normal ejection fraction?

Answer 17

50%

70ml

Question 18

most common valve lesion?

Answer 18

calcific aortic lesion in ppl aged 70-80s

Question 19

aortic stenosis symptoms?

Answer 19

SAD, only when severe
syncope
angina
dyspnoea

Question 20

best place to hear aortic stenosis?

Answer 20

upper right sternal edge with diaphragm

Question 21

where can you hear severe aortic stenosis?

Answer 21

base and apex

Question 22

when do aortic stenosis replacement?

Answer 22

usually not until symptoms

(S)tenosis - Symptoms

Question 23

causes of aortic regurg? re: valves, roots

Answer 23

valves: endocarditis, Rheum. Fever
root: Marfans, dissection, syphilis

Question 24

decribe aortic regurg pulse pressure?

Answer 24

wide pulse pressure?

Question 25

what kind of pulse in aortic regurg?

Answer 25

water-hammer pulse/collapsing pulse

Question 26

aortic regurg sound?

Answer 26

after S2 - collapse: in diastole

Question 27

causes of mitral regurg

Answer 27

myxomatous degen

mitral valve prolapse

Question 28

cause of sudden mitral regurg?

Answer 28

ruptured chordae tendinae

Question 29

mitral regurg murmur sound?

Answer 29

pan-systolic: same intensity throughout, finishes after S2

Question 30

mitral stenosis sound?

Answer 30

diastolic rumbling murmur

Question 31

mitral stenosis affects what?

Answer 31

left atrium due to pressure overload

-AF

Question 32

tricuspid regurg cause?

Answer 32

right ventricular failure from pulmonary hypertension