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1, Cardiology > Heart Valve Problems > Flashcards

Heart Valve Problems Flashcards

1
Q

What is at “thrill” when describing a murmur?

A

-if you were to put your hand where your hearing the murmur you would feel fluid moving under your hand

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2
Q

When grading a murmur(s) 1 through 6 where do you feel a thrill?

A

-you feel a thrill in the 4-6 murmurs

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3
Q

What is the pnuemonic for aortic stenosis ?

A

ASH

angina, syncope, heart failure

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4
Q

What makes up the S1 heart sound?

A

-the closing of the mitral and tricuspid valves, M1 and T1

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5
Q

What makes up the S2 heart sound?

A

-the closing of the aortic and pulmonic valves, A2 and P2

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6
Q

How do you get an S3 heart sound?

A

-the splashing of blood into the ventricle in CHF

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7
Q

What is the S4 heart sound?

A

-the sound of a stiff ventricle, in diastolic CHF or ischemia

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8
Q

When will you hear a rub when auscultating the heart?

A

-pericarditis, (so pericardial friction rub)

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9
Q

What is a Gallup?

A
  • S1 and S2 plus an S3–think systolic CHF

- S1 and Sw plus an S4–think diastolic CHF or ischemia

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10
Q

You hear a fixed splitting of S2 in the pulmonic listening area, and you palpate a left peristernal lift. What’s the Dx?

A

-ASD

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11
Q

A chest x-ray shows increased pulmonary arteries and increased pulmonary vascularity. You note a fixed splitting of S2 and a peristernal lift. What is the Dx?

A

-ASD

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12
Q

What is coarctation of the aorta?

A

-narrowing of the aorta, usually distal to the subclavian artery

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13
Q

Boy presents with calf cramping with exercise. He has higher BP in arms than legs and a brachial femoral pulse lag. What is the Dx? How do you follow and counsel parents on sibilings?

A
  • coarctation of the aorta

- He needs to be followed and so do siblings because he is going to get hypertrophic cardiomyopathy, so will siblings.

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14
Q

Kid has calf cramping and 3 sign/ rib notching on x-ray. What’s he got?

A

-coarctation of the aorta

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15
Q

Lower BP in legs and rib notching on CXR.

A

-coarctation of the aorta

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16
Q

Continuous machinery murmur. Baby has failure to thrive. (Adult is asymptomatic). Dx and Tx?

A

Dx is patent ductus arteriosis

Tx for baby is indomethacin

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17
Q

Pansystolic/Holosystolic murmer mid sternal border.

A

VSD

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18
Q

Most common heart defect

A

VSD

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19
Q

This shunting starts left to right but then ends right to left. What is significant when it becomes right to left?

A

VSD

-surgery is not longer possible when it ends in right to left (Eisenmenger syndrome)

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20
Q

kid with TET spells, (squatting child)

A

Tetralogy of fallot (squats and it goes away)

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21
Q

kid has RVH, VSD, PS and overriding aorta

A

Tetralogy of fallot

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22
Q

Which kids should you be suspicious of tetralogy of fallot?

A
  • Down’s Syndrome
  • Di George Syndrome
  • congenital rubella
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23
Q

What kids get transposition of the great vessels?

A

mom is diabetic

24
Q

Cor Pulmonale from congenital heart defects, left to right shunting then right to left shunting?

A

-Eisenmenger syndrome, to late to do surgery when the shunt gets to right to left.

25
Q

Patient presents with (ASH) chest pain (angina), syncope with effort, and heart failure. PE shows narrow pulse pressure, apical lift, S4 gallop, and slow carotid upstroke w/murmur. What’s he got?

A

-Aortic Stenosis

26
Q

How do you treat aortic stenosis?

A
  • valve replacement

- Nitro and ACEI may cause severe hypotension, as they already have low pulse pressure

27
Q

In a young patient with ASH, angina, syncope, and heart failure (S4 heart sound), what is his problem?

A

-bicuspid aortic valve

28
Q

Austin Flint murmur

A

low pitched rumbling murmur heard best the cardiac apex

heard in Aortic Regurgitation

29
Q

Patient presents with fatigue and dyspnea, palpitations, and chest pain (angina). On exam he has a low pitched rumbling murmur heard at the cardiac apex.

A

-Aortic Regurgitation

30
Q

What happens to the Aortic valve such that one gets aortic regurgitation?

A
  • Leaflet degeneration: 1, rheumatic fever, 2 endocarditis, 3, connective tissue disorders
  • Aortic Root enlargement: 1, HTN, Marfan’s, Syphilis,
31
Q

What is the Tx for Aortic Regurgitation?

A

-ACEI, Bblocker, loop diuretic

32
Q

Patient comes in with PHD, palpitations (a-fib), heart failure (CHF), and dyspnea with exertion. Auscultation shows opening snap and low pitched diastolic rumble at the apex.

A

-Mitral Stenosis

33
Q

What is the treatment for mitral stenosis?

A

-medical, slow down the heart to allow for better filing—give them a beta blocker or a calcium channel blocker

34
Q

Holosystolic murmur radiating to the axillae

A

-Mitral Regurgitaion

35
Q

Tx for Mitral Regurgitation

A

-Medical, Bblocker, loop diuretic, ACEI

36
Q

Young woman with sharp stabbing pain and palpitations presents. She is noted to have a mid systolic click and and late apical systolic murmur? what is her murmur?

A
  • Mitral Valve Prolapse

- Tx with reassurance and maybe a Blocker

37
Q

young adult (> 50) or old person comes in with ASH, (angina, syncope, heart failure). They have a narrow pulse pressure, apical lift, S4, and a slow carotid upstroke. What valve disorder do they have?

A

Aortic stenosis

if this is a real young person think HOCM (hypertrophic cardiomyopathy

38
Q

A young person with aortic stenosis think of what problem?

A

-bicuspid aortic valve

39
Q

Gallivardin’s phenonemon

A

Aortic stenosis, musical murmur, low rumble that radiates to the carotids

40
Q

Austin Flint muruer

A

Aortic regurgitation

41
Q

person has fatigue and dyspnea and Austin Flint murmur, whats the Dx?

A

-Aortic regurgitation

42
Q

murmur following opening snap, and is decrescendo, low pitched diastolic rumble best heard at the apex. Patient has palpitations, HF, and dyspnea with exertion.

A

-Mitral stenosis

43
Q

What are the symptoms of mitral stenosis?

A

(PHD), palpitations (a-fib), heart failure, dyspnea with exertion.

44
Q

What is the treatment for mitral stenosis?

A

-Bblocker or calcium channel blocker to slow the heart in order to allow for better heart refill, longer diastole.

45
Q

Halosystolic murmer, high pitched, best heard at the apex with the diaphragm in the left lateral decubitus position, radiates to the axilla.

A

-Mitral regurgitation

46
Q

What are the symptoms of mitral regurgitation?

A

-same as for mitral stenosis, PHD, palpitations, heart failure, dyspnea with exertion

47
Q

What is the tx for mitral regurgitation?

A

surgery

if they refuse surgery, tx with Bblocker, loop diuretic, ACEI, (so tx like heart failure)

48
Q

Young lady with sharp jabbing chest pain, palpitations but no EKG changes or arrhythmia, and short of breath (dyspnea). Heart exam includes mid-systolic click and late apical systolic murmur. What is the Dx?

A

-Mitral valve prolapse

49
Q

Mid diastolic murmur best heard over the left sternal border with rumbling. Patient has JVD, so it looks like right heart failure. Has a hx of rheumatic fever.

A

tricuspid stenosis

50
Q

What is the tx for tricuspid stenosis?

A

surgery

51
Q

Patient has a pansystolic murmur with Carvallo sign, best heard on left sternal border. Patient has used fen-Phen (dexfenfluramine) or is an IV drug user or has pulmonary hypertension.

A

-tricuspid regurgitation

52
Q

Patient has pulmonary hypertension now comes in with complaints of dyspnea with exertion. She has a Gramsteel murmur. What is the Dx?

A

-Pulmonary regurgitation

53
Q

high pitched diastolic decrescendo murmur, left upper mid sternal area, patient has pulmonary hypertension.

A

Gramsteel murmur

54
Q

kid with Noonan syndrome has SOB anda crescendo decrescendo murmur left upper sternal border that increases with inspiration and radiated diffusely.

A

Pulmonary stenosis

55
Q

middle aged guy with carcinoid syndrome has SOB and a crescendo decrescendo murmur left upper sternal border that increases with inspiration and radiates diffusely.

A

Pulmonary stenois

56
Q

What do you do for continued tx for a person with a mechanical valve.

A
  • warfarin therapy, INR 2.5-3.5

- you should hear a click on auscultation if not there is a problem

1, Cardiology (11 decks)

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