Johnston Valvular Disorders

Question 1

ecg in left atrial enlargement p wave

Answer 1

biphasic in V1

m shaped in I

Question 2

chronic mitral regurg cause

Answer 2

MVP- most common etiology

mitral annular calcification

Question 3

acute mitral regug cuase

Answer 3

rupture of chordal tendineae
rupture of papilary muscle
ischemic papillary m dysfunction

Question 4

MR symptoms

Answer 4

acute: volume overload, orthopnea, pnd, rhf and lhf (pulmonary symptoms)

Question 5

treatment of MR

Answer 5

vasodilators (decrease afterload)

ace inhibtors for chronic

Question 6

treatment of MVP and thyroid disorder

Answer 6

beta blocker

regulate thyroid meds

Question 7

mortality in AS

Answer 7

without treatment most will die within 3 years

Question 8

physical exam AS

Answer 8

narrow pulse pressure
decreased sv and systolic pressure
delayed pulse
systolic murmur radiates into supra sternal notch/carotids
gallavardin phenomenon- murmr radiates to apex

Question 9

causes of acute AR

Answer 9

IE, aortic dissection, Bicuspid aortic valve

Question 10

causes of chronic AR

Answer 10

syphilis, ankylosing spondylitis

Question 11

treatment of AR

Answer 11

ARB

surgery when symptomatic or EF < 55%

Question 12

tricuspid stenosis ecg

Answer 12

prominent A wave in JVP ascites, hepatomegalia

Question 13

murmur in triscuspid stenosis

Answer 13

diastolic murmur LSB; increase with inspiration and decrease with expiration

Question 14

TR and waves

Answer 14

prominent V wave

Question 15

what is associated with tricuspid regurgitation

Answer 15

pulmonary HTN, inferior MI/RV infarction and others

Question 16

murmur in tricuspid regurg

Answer 16

blowing systolic murmur lsb increase with inspiration

Question 17

pulmonary stenosis murmur

Answer 17

2nd-3rd ICS, LSB/radiates toward left shoulder and increases on inspiration