Heart Valves Flashcards
Which type of murmurs begin and end in the LV?
Systolic begin and Diastolic end
How does mitral regurgitation affect cardiac output and preload?
Decrease forward cardiac output
Increased preload
What will cause a new systolic murmur after MI?
New Diastolic murmur associated with chest pain?
New VSD or New MR
Aortic regurgitation after dissection
Why might MR happen after MI?
Ruptured chordae tendinae
What physical features maybe associated with MVP?
Scoliosis and pectus excavatum
What is the MVP murmur?
Mid-systolic click with possible late systolic murmur
MR symptoms?
LVHF
RVHF with increasing severity
MR murmur?
Holosystolic murmur that radiates to axilla (often has a thrill)
Why is there an S3 in MR?
Also has what other heart sound?
Rapid filling of the ventricle b the large volume of blood accumulated in the left atrium during systole.
Widely split s2
What may your ekg show for MR?
What’s the Dx TOC?
LVH, LAE
Echo
management of MR?
Vasodilator (ACEI) - reduce resistance to aortic flow
Surgery severe
Narrowing of the aortic valve causes a pressure overload on what? Leading to?
LV
LVH
Risk factors for AS?
3
HTN
High cholesterol
Smoking
Symptoms of AS? 3
Syncope
Angina- hypertrophied left ventricle, lack of flow to CA
Dyspnea
Sign of AS?
Delayed carotid upstroke
What is the AS murmur?
Harsh crescendo-decrescendo systolic ejection murmur
What will you find on ekg with AS?
LVH
Treatment of AS?
Maybe diuretics
Valve replacement
Possible causes of AR?
4 (MC)
HTN
Syphilis
SLE
Marfan
AR symptoms?
Left ventricular failure
Syncope
AR murmur?
Radiates to?
Heard best how?
High pitched decrescendo blowing diastolic murmur
Apex
Leaning forward or PT sitting
What is another murmur associated with AR?
Austin flint murmur
AR is associated with which physical exam signs? 2
Increased stroke volume and wide pulse pressure
AR ekg?
TX?
LVH
Surgery
MC Etiology of mitral stenosis?
Rheumatic
MS causes which kind of structural heart issues?
LVHF progressing to RVHF
MS can cause which symptoms? 2
Hemoptysis
Hoarseness
MS murmur?
Diastolic low pitched rumble
EKG for MS? 3
Atrial fibrillation, LAE, RVH
MS opening snap caused by what?
By delay of thick stenotic valve to finally open
TX of MS?
3
Diuretics are mainstay of TX!
BB
Surgery for severe
What are the three types of continuous murmurs?
Pericardial friction rub
PDA- systolic
Venous hum- diastolic
Which maneuvers accentuate HOCM and MVP?
Mitral regurgitation?
Standing increases murmur (dec LV size)
Squatting decreases murmur (inc LV size)
Standing decreased
Squatting increased
Major criteria for jones? Minor? How many for dx? Which valve? TX?
Carditis, polyarthritis, chorea, erythema marginatum, nodules
Fever, arthralgias, prolonged QT, increased ESR, CRP
2 major, 1 major and 2 minor
Mitral
Penicillin or Erythromycin
Most common bugs in Endocarditis:
Native valve? (Acute, subacute)
IVDU?
Prosthetic valve?
Staph, Strep (viridans)
Staph with the tricuspid
Staph
Signs of endocarditis? 4
DX?
TX?
Splinter hemorrhages
Osler’s nodes
Jane way lesions
Roth Spots
Blood cultures
Echo
Empiric: Vanco and Ceftriaxone
Staph: Naph and Vanco
Strep: IV pen
