Lecture 4: Valvular Heart Disease Flashcards
where do we auscultate for the pulmonary area
- left side
- towards sternum, 2nd intercostal space
where do we auscultate for the aortic area
- right side
- towards sternum, 2nd intercostal space
where do we auscultate for the tricuspid area
- left side
- left sternal edge
- 4th intercostal space
where do we auscultate for the mitral area
- left side
- 5th intercostal space
what are the types of valvular heart disease and who do they affect
- degenerative: most common, affects aging population
- rheumatic: affects children and young adults in poorer populations
- infective: affects immunocompromised and abnormal valves
which valves are affected by the different types of valve diseases
- degenerative: aortic more than mitral
- rheumatic: mitral more than aortic
- infective: any valve, left heart more than right, right seen in intravenous drug users
what are the pathologies of valve disease
- calcification, immobility of leaflets
- fibrosis, fusion of leaflets
- dilatation of valve ring
what are the severe symptoms of aortic stenosis
SAD Triad:
- syncope upon exertion
- angina
- dyspnoea
- fatigue, palpitations
what are the symptoms of mild-moderate aortic stenosis
asymptomatic, murmur discovered on routine exam
what are the heart murmurs to listen out for in aortic stenosis
- loud S1 during systole
- in severe cases, softer second sound
what are causes of aortic regurgitation
- hypertension
- connective tissue disease, eg rheumatoid arthritis
- infective endocarditis
- bicuspid valve replacements
what are the heart murmurs to listen out for in aortic regurgitation
sound after S1
symptoms of aortic regurgitation
- often asymptomatic
what are the causes of mitral regurgitation
- valvular prolapse, infection
- chordal rupture / papillary muscle failure
- annular dilatation
what are the murmur sounds to listen for in mitral regurgitation
long S1 during systole
