Lec 3 Valvular Heart Diseases Flashcards
<p>What is the normal mitral valve orifice?</p>
<p>4-6 cm2</p>
<p>What is the mean gradient in moderate mitral stenosis?</p>
<p>5-10mmHg</p>
<p>What valvular heart disease manifests with malar flush with pinched and blue facies?</p>
<p>Mitral Stenosis</p>
<p>What are Kerley B Lines?</p>
<p>They are fine, dense, opaque, horizontal lines that are most prominent in the lower lung fields. These are usually seen when resting LA pressure >20 mmHg and is caused by interstitial pulmonary edema, fibrosis, or hemosiderin deposition.
</p>
<p>What are the other conditions aside from RHD that cause mitral valve stenosis?</p>
<p>Almost all are rheumatic. You can’t make a diagnosis of idiopathic mitral valve stenosis here in the Philippines.</p>
<p>What is an Austin-Flint murmur?</p>
<p>Seen in AR. Soft mid-diastolic short rumble at apex due to regurgitant stream and mid-systolic ejection murmur.</p>
<p>What is Bisferiens pulse?</p>
<p>A palpable double systolic arterial pulse.</p>
<p>AR or AS? Manifests with widened arterial pulse.</p>
<p>AR because of the </p>
<p>What is Demusset’s sign?</p>
<p>Abrupt distention and collapse of larger arteries</p>
<p>What is Corrigan Pulse?</p>
<p>▪ “water-hammer” pulse
| ▪ collapses suddenly as arterial pressure falls rapidly during late systole and diastole</p>
<p>What is Quincke’s Pulse?</p>
<p>capillary pulsations while pressure is applied to the tip of the nail (characteristic of a free AR)</p>
<p>What is Traube’s sign?</p>
<p>“pistol-shots” over femoral arteries</p>
<p>What is Durozier’s sign?</p>
<p>to-and-fro murmur with femoral artery compression</p>
What is the Carvallo’s sign?
Holosystolic murmur intensified in inspiration seen in TR.
Should the pulmonic valve be catheterized?
Catheterization of the pulmonic valve is discouraged because of the infundibular thickening in which the catheter might be stuck, causing the patient to arrest – suicide of the right ventricle.
Arrange the four valves in order of likelihood of involvement in RHD.
Mitral > Aortic > Tricuspid > Pulmonic
P.E. Findings: Opening snap -> Loud S1
Mitral Stenosis
What conditions other than AR are associated with widened arterial pulse?
PDA and AV fistula
What valvular disease is associated with Marfan’s syndrome?
Aortic Regurgitation
P.E. Findings: S1 absent or soft murmur, with widely split S2
Mitral Regurgitation
Most common cause of valvular heart disease in the Philippines?
Rheumatic
P.E. Findings: Loud P2
Pulmonary Insufficiency
P.E. Findings: Bounding Pulse
Aortic Regurgitation
P.E. Findings: Ascites and Edema
TR and TS :)
Symptom: Exertional dyspnea and paroxysmal nocturnal dyspnea (PND)
Mitral Stenosis
Formula for EF%
(LVEDD^3 - LVESD^3) / LVEDD^3
Presents with a prominent a wave and gradual y descent.
Mitral Stenosis
Presents with hoarseness of voice.
Mitral Stenosis
Signs of Carcinoid syndrome
▪ Flushing of the skin
▪ Diarrhea
▪ Secondary restrictive cardiomyopathy
