Lecture 21 - The Cardiac Cycle and Valve Disorders of the LEFT Heart

Question 1

Murmurs caused by stenotic valves will be heard when the valves should be fully _____, while murmurs caused by insufficient valves will be heard when the valves should be fully _____.

Answer 1

Open

Closed

Question 2

Mitral valve stenosis can cause a murmur to be heard during mid-______ (systole or diastole?), and it can also cause an Opening _____ murmur (when the valve opens before it typically should bc of elevated pressure in the ____ ______.) It is most commonly caused by _____ _____ disease secondary to Strep A pharyngitis.

Answer 2

mid-Diastole

Opening Snap murmur

Left Atrium

Rheumatic Heart Disease

Question 3

Atrial enlargement resultant from Mitral valve stenosis can cause abnormal electrical activation, leading to _____ _____.

Answer 3

Atrial Fibrillation

Question 4

Mitral valve regurgitation results in a _________ murmur, which is best heard over the _____ ventricle and it can result in an _____ sound.

Left _______ hypertrophy and dilation from increased EDV is characteristic of CHRONIC Mitral regurg.

Answer 4

Holosystolic murmur

Left ventricle

S3

Left Ventricular hypertrophy

Question 5

Aortic regurg is commonly caused by connective tissue disorders, including ______ syndrome and _____-_____ syndrome. Remember the Aortic valve is typically shut during ______ (systole or diastole?). Bacterial endocarditis and other inflammatory disease states can also cause Aortic regurg.

Answer 5

Marfan (FBN-1 gene defect)

Ehler-Danlos syndrome (Collagen defect)

Diastole

Question 6

Given the changes in the blood volume in the Aorta and Left Ventricle, respectively, in Aortic regurg, how do systolic, diastolic, and pulse pressure change?

Answer 6

Systolic will increase bc LV initially pumps more blood into the Aort, as its volume increases from diastolic backflow.

Diastolic pressure will decrease in the Aorta bc of the backflow into the left ventricle.

With and increase in systolic and decrease in diastolic, there is a widened pulse pressure.

Question 7

Aortic stenosis can lead to a mid-______ (systolic or diastolic?) murmur as well as an _____ murmur (the latter causes an _____ sound before S1).

Answer 7

mid-Systolic

Ejection murmur

Ejection sound before S1