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ICM-CARDIO > Lecture 7 Valves > Flashcards

Lecture 7 Valves Flashcards

1
Q

what valve only has 2 leaflets?

A

mitral

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2
Q

what is the largest heart valve?

A

tricuspid

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3
Q

3 potential causes to tricuspid stenosis:

A

rheumatic fever, carcinoid, congenital

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4
Q

Rheumatic fever typically affects the _____, followed by the _____, and ____ valves

A

mitral, aortic, tricuspid

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5
Q

carcinoid syndrome is secondarty to ____ production from ___ metastasis

A

serotonin;

liver

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6
Q

carcinoid syndrome can cause ____ sided valvular disease, such as fibrous plaque formation–> _____ and _____

A

right;

stenosis and regurgitation

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7
Q

symptoms of tricuspid stenosis

A

excessive fatigue and dyspnea

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8
Q

tricsupid stenosis forward failure: decreased ____ of the LV; thus decreased _____ _____

A

preload; stroke volume

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9
Q

tricuspid stenosis backward failure: hepatic _____ and peipheral ____

A

edema, congestion

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10
Q

Tricuspid stenosis:

mid ____ murmur over the ____ _____ _____ border. murmur _____ on inspiration

A

diastolic; lower left sternal;

increases

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11
Q

triscupid regurgitation:
_____ murmur heard best over the ____ ____ border;
murmur ____ with inspiration

A

pansystolic; lower sternal;

increases

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12
Q

tricuspid regurg:
liver is ____ and shows systolic ____;
hepatojugular reflux present

A

enlarged, pulsatations

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13
Q

majority of the tricuspid regurg patients will get ____ ____

A

atrial fibrillation

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14
Q

pulmonary valve lesions are typically due to ____ reasons

A

congenital (ie tetralgy of fallot, pulmonary atresia)

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15
Q

mitral stenosis:

decreased flow of blood to the ____ causes decreased cardiac ____ –> symptoms of fatigue, muscle wasting, weakness

A

LV; output

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16
Q

mitral stenosis:

there is ___ hypertrophy, which can cause fibrillation or mural thrombi. there is also increased ____ _____ resistence

A

LA;

pulmonary vascular

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17
Q

The classic symptom of mitral stenosis is ____ on ____

A

dyspnea, exertion

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18
Q

the auscultory triad of mitral stnosis is what?

A

apical diastolic rumble + increased S1 + opening snap

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19
Q

with severe mitral stenosis, ____ ____ can be seen, due to engorged pulmonary lymphatics

A

kerley’s lines

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20
Q

what is by far the most common cause of mitral stenosis? what is the timing of the cause?

A

rheumatic fever, late lesion

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21
Q

echo of mitral stenosis will show ____ enlargment and leaflet ____ secondary to restrictive opening of the valve

A

LA;

doming

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22
Q

mitral regurg is due to _____ heart disease, ____ rheumatic fever, mitral valve _______; orconnective tissue disease such as ____, _____, or osteogenesis imperfecta

A

ischemic; early;
prolapse;
ehler’s-danlos, marfan syndrome

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23
Q

mitral regurg:

increased ____ pressure, ____ pressure, and pulmonary vein pressure

A

LA; pulmonary capillary wedge

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24
Q

mitral regurg:

symptoms include fatigue, dyspnea, decreased ____ toleranace, palpitations, and _____ _____

A

exercise; atrial fibrillation

25
Q

if chronic, mitral regurg results in ____ hypertrophy.

A

LA

26
Q

if acute mitral regurg, such as ruptured ____ ____ post ____, then the increased in blood to the LA causes acute ____ ____

A

papillary muscle, MI;

pulmonary edema

27
Q

patients with mitral regurg have increased susceptibility to ____ ____

A

bacterial endocarditis

28
Q

in mitral regurg, the mitral ____ dilates _____

A

annulus, posteriorly

29
Q

the normal aortic valve has ___ cusps. it is a ____ valve

A

3, semilunar

30
Q

aortic stenosis is due to age-related ____, or early onset ____ if the patient has a _____ valve

A

calcification, calcification; bicuspid

31
Q

____ is another cause of aortic stenosis, but it is typically also associated with the ____ valve

A

rheumatic fever;

mitral

32
Q

aortic stenosis causes an increase in ____, with secondary impaired ___ emptying during _____

A

afterload; LV, systole

33
Q

aortic stenosis causes a ____ _____ hypertrophy

A

concentric LV

34
Q

Aortic stenosis: LV Hypertrophy with increased ____ ____ –> increased ___ demand and decreased ____ ____ during diastole. This, ____ can occur during exercise

A

muscle mass; O2, subendocardial flow; angina

35
Q

classic symptoms of aortic stenosis: acronym? and what each letter stands for

A

SAD

syncope, angina, dyspnea

36
Q

Aortic stenosis can result in sudden death due to _____ ____ or if untreated, can cause gradual ____ _____ _____

A

ventricular arrhythmia, congestive heart failure

37
Q

aortic stenosis:

____ ____ murmur heard best in the ____ ____ ____ that radiates to the ____

A

systolic ejection; right 2nd intercostal space; carotids

38
Q

An aortic valve area (AVA) less than ____ or an ejection fraction less than ____is considered severe as seen on Echo. What is indicated?

A

.8 cm squared; 50%

surgery

39
Q

causes of aortic regurg:

mixed aortic stenosis, aortic root dilatation (______ _____), congenital (____ valve), rheumatic fever, endocarditis

A

annuloaortic ectasia;

bicuspid

40
Q

aortic regurgitation is the most common valvular lesion in ____ ___ ____

A

blunt chest trauma

41
Q

what 2 rheumatic disease are associated with aortic regurg?

A

rheumatoid arthritis;

ankylosing spondylitis

42
Q

Aortic regurg results in volume ____ of the ____. This results in increased _____ and wall stress.

A

overload, LV;

LV end diastolic pressure

43
Q

Aortic regurg:
increased LVEDP causes progressive LV ____, eventually leading to ____ ____ of the LV (increased ____ size and increased ____ thickness)

A

dilatation;

eccentric hypertrophy; CHAMBER*; wall

44
Q

___ ____ is massive dilatation of the LV

A

Cor Bovinum

45
Q

Aortic regurg:

LV failure –> fall in ____ and _____ until CO can not be maintained.

A

contractility, ejection fraction

46
Q

Aortic regurg:
______ ischemia from decreased _____ coronary blood flow, increased ventricular pressure, LVH, and increased workload –> ____ despite normal coronaries

A

subendocardial; diastolic;

angina

47
Q

Aortic regurg:
____ ____ murmur;
____ pulse pressure due to ____ systolic and _____ diastolic pressure

A

diastolic blowing;

widened, increased, decreased

48
Q

Aortic regurg:
____ ____ pulse = bounding and forceful peripheral pulse;
_____ = forceful carotid pulse;
______ = forceful limb pulse

A

water hammer;
corrigan’s;
watson’s

49
Q

Aortic regurg: what is de musset’s sign?

what is quincke’s pulse?

A

bobbing of head with cardiac cycle;

pulsating nail beds

50
Q

aortic regurg:
austin flint murmur - when regurgitant jet hits the anterior leaflet of the ____ ____, causes closure –> murmur at the ____

A

mitral valve;

apex

51
Q

aortic regurg:
_____ sign = systolic and diastolic murmur over the femoral arteries;

____ sign - pistol shot sounds over the large arteries

A

duroziez’s;

traube’s

52
Q

____ ____ is unexplained LVH associated with a non-dilated ventricle in the absence of another cardiac or systemic condition

A

hypertrophic cardiomyopathy (HCM)

53
Q

HCM:

____ ____ dysfunction, with dynamic ____ outflow obstruction, often at rest

A

LV diastolic, LV

54
Q

HCM: often see ____ anterior motion of the ____ valve and ____ regurg

A

systolic; mitral; mitral

55
Q

what heart sound is often seen with HCM?

there is also a ____ ____ murmur and a holosystolic murmur of ____ ____

A

S4

systolic ejection; mitral regurg

56
Q

HCM:

____ carotid ____ aka ‘______’

A

bisferiens upstroke; spike and dome

57
Q

maneuvers to decrease the LV size and make an HCM murmur louder: _____ and ____

maneuvers to increase the LV size and make a murmur softer: ______ and ____

A

standing, valsalva maneuver;

squatting, handgrip exercise

58
Q

HCM causes ____ during exercise. It can also cause sudden death in young athletes due to ____ _____. Can also cause CHF symptoms

A

syncope ;

ventricular arrhythmia

59
Q

Patients with HCM should restrict ____. If at a high arrythmic risk, they should receive an ____

A

exercise;

ICD

ICM-CARDIO (11 decks)

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