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T2: Theme 3: CVS > Lecture 4: Valvular heart disease > Flashcards

Lecture 4: Valvular heart disease Flashcards

1
Q

What are the mid systolic murmurs?

A

Aortic stenosis
Pulmonary stenosis
(also atrial septal defect and HOCM)

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2
Q

What are the holosystolic murmurs?

A

Mitral regurgitation
Tricuspid regurgitation
(also VSD)

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3
Q

What is the late systolic murmur?

A

Mitral valve prolapse

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4
Q

What are the early diastolic murmurs?

A

Aortic regurgitation
Pulmonary regurgitation
(also Austin-Flint)

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5
Q

What are the mid/late diastolic murmurs?

A

Mitral stenosis

Tricuspid stenosis

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6
Q

What does pan systolic mean?

A

Spans across both heart sounds

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7
Q

What is the epidemiology of degenerative valve disease?

A

Ageing population

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8
Q

What is the epidemiology of Rheumatic valve disease?

A

Post-streptococcal rheumatic fever

Children and young adults

Disease of poverty and overcrowding

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9
Q

What is the epidemiology of infective valve disease?

A

Most common on abnormal valves

Virulent organisms (normal valves, strep/staph)

Immunocompromised

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10
Q

What is the epidemiology of congenital valve disease?

A

Low, static incidence in all populations

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11
Q

Which valves are affected by degenerative valve disease?

A

Aortic > Mitral

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12
Q

Which valves are affected by rheumatic valve disease?

A

Mitral > Aortic

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13
Q

Which valves are affected by infective valve disease?

A

Any valve (left more often than right)

Right if atypical - IVDU

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14
Q

Which valves are affected by congenital valve disease?

A

Any

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15
Q

What is the most common cause fro AS, AR, MR?

A

Degeneration

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16
Q

What is the most common cause for mitral stenosis?

A

Rheumatic fever

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17
Q

What is stenosis?

A

Narrowing of valve leaflets

Valve leaflets fail to open completely

Leads to build up of back pressure and loss of stroke volume

18
Q

What is regurgitation?

A

Failure of leaflets to meet in systole

Leaflets fail to close completely

Allows reverse flow of blood during relaxation of the heart

AKA incompetance

19
Q

Which valve problem is pressure dependent?

A

Stenosis

20
Q

Which valve problem is volume dependent?

A

Regurgitation

21
Q

What are the symptoms of aortic stenosis?

A

The SAD triad:

  • Syncope
  • Angina
  • Dyspnoea

Fatigue - decreased exercise tolerance

Sudden death

22
Q

What condition can give signs similar to aortic stenosis?

A

Hypertrophic obstructive cardiomyopathy

23
Q

What murmur does aortic stenosis cause?

A

Systolic crescendo/decrescendo

24
Q

What causes aortic regurgitation?

A

CREAM

Congenital
Rheumatic damage 
Endocarditis 
Aortic dissection 
Marfans
25
Q

What causes LV dilatation?

A

Volume overload

26
Q

What causes LV hypertrophy?

A

Pressure overload

27
Q

Which condition causes LA enlargement?

A

Aortic regurgitation

28
Q

What murmur is caused by aortic regurgitation?

A

Early diastolic murmur

29
Q

What are the symptoms of aortic regurgitation?

A 
Often asymptomatic 
Chest pain
Breathlessness
Syncope 
Catastrophic decompensation
30
Q

What causes MR?

A

Valve prolapse, infection, degeneration

Chordal rupture

Annular dilation (secondary to LV dilatation)

31
Q

What are the consequences of AR?

A

Volume overload in LV

LV dilatation

Late decompensation of LV function

High volume circulation

32
Q

What are the consequences of MR?

A

Volume overload in LV

Pressure overload of right heart - hypertrophy

LV dilatation

Decompensation

33
Q

What causes a pan-systolic murmur?

A

Mitral regurgitation

34
Q

What are the symptoms of MR?

A

Breathlessness

Lethargy and reduced exercise tolerance

Palpitations - AF

Peripheral oedema

Chest pain

35
Q

What condition causes a mid-systolic click with a late systolic murmur?

A

Mitral valve prolapse

36
Q

What causes MS?

A

(Almost always) Rheumatic fever

Congenital

Storage disease

Malignancy

37
Q

What are the consequences of MS?

A

Breathlessness/congestion - due to pressure back up

Left ventricle physiology usually preserved

38
Q

What causes a mid-diastolic rumbling murmur?

A

MS

39
Q

What are the symptoms of MS?

A 
Breathlessness
Peripheral oedema 
Haemoptysis 
Palpitations
Systemic emboli 
Fatigue 
Stridor/dysphagia
40
Q

What is the limitation of biological valve replacements?

A

Only last ~10 years

41
Q

What is the limitation of mechanical valve replacements?

A

On warfarin for the rest of life

T2: Theme 3: CVS (18 decks)

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