Malozzi-Valvular Heart Disease Flashcards
structure that holds heart valves in position
chordae tendinae
3 cusps
semilunar valves
2 leaflets
mitral valve
3 leaflets
tricuspid valve
to diagnose valvular heart disease
- hx
- auscultation
- tests
2 most important ways to diagnose valvular heart disease
auscultation
echo
this type of murmur grows louder
crescendo murmur
this type of murmur grows softer
decrescendo murmur
this type of murmur first rises, then falls
crescendo-descrescendo murmur
murmur that has same intensity throughout
plateau murmur
valvular______leads to pressure overload
stenosis
valvular _______ leads to volume overload
insufficiency/regurgitation
valvular stenosis can ultimately lead to what
concentric hypertrophy/remodeling
valvular insufficiency/regurgitation can ultimately lead to what
eccentric hypertrophy
this valve pathology is due to age and congenital (bicuspid valve)
aortic stenosis
what does the LV compensation to an obstruction in flow eventually lead to
concentric hypertrophy
when LV can no longer compensate, what happens
eccentric hypertrophy and heart will fail
3 main sx’s of progressive aortic stenosis
syncope
angina
dyspnea
once symptoms develop for aortic stenosis, what is mortality rate
ave. survival up to 5 years
how can you decipher severity of aortic stenosis murmur
the duration
what is not a factor for severity of aortic stenosis
intensity of murmur
more stenosis will eventually lead to _______ sounds
quieter
calcifications on bicuspid aortic valve
what do you need to think about with aortic stenosis if patient has symptoms
possible valve replacement
what do you need to do to classify aortic stenosis in patient with no symptoms
look at velocity of blood flow across valve
common causes of this include:
structural defects
stretching of aorta
tertiary syphilis
aortic dissection
RHD (underdeveloped countries)
aortic regurgitation
aortic regurgitation causes what three main things to increase
increased volume into LV
increased preload
increased afterload
how is aortic regurgitation murmur best heard
at LUSB w/ patient leaning forward and listen after they have exhaled
what to do if patient is symptomatic for aortic regurg
discuss valve replacement
what to do if patient is asymptomatic for aortic regurg
check LVEF (if dropping means not able to compensate)
this phase of mitral regurgitation causes sudden decrease in CO (cardiogenic shock)
Acute
this phase of mitral regurgitation allows for compensation
chronic
holosystolic murmur heard at apex of heart
mitral regurgitation
to diagnose mitral regurgitation
CXR
EKG
Echo
what will you find on CXR if patient has mitral regurg
cardiomegaly
pulmonary edema
what will you find on EKG if patient has mitral regurg
LA enlargement or Afib
what to do if patient has primary Mitral regurg (no symptoms)
nothing
what to do if patient has mitral regurg w/ symptoms and LV dysfunction
discuss valve replacement
what to look at for any of these valve pathologies to decide whether to do surgery or not to replace them
LVEF
mitral valve prolapse
exaggerated billowing of mitral valve leaflets into atrium during systole
mitral valve prolapse
mainly seen in young women; people who are tall and slender (Marfan’s)
mitral valve prolapse
most common cause is RF (uncommon in clinical practice today)
mitral valve stenosis
diastolic murmur heard best at L lateral decubitus position at apex
mitral valve stenosis
this valve pathology really doesn’t have symptoms and is very common; heard at LLSB (systolic)
tricuspid regurgitation
cause of tricuspid regurgitation
endocarditis (IV drug use)
murmur increases with inspiration
Tricuspid regurgitation
what to do in the case of severe tricuspid regurgitation
surgery; can remove valve
2 main determining factors for valve replacement:
age
if pt. can take anti-coagulants
best type of valve replacement for people under age of 50
mechanical (metal); lasts a while
best type of valve for older patients
bioprosthetic (doesnt last as long)
to dx Rheumatic heart disease
2 major sx’s
or
1 major and 2 minor sx’s
Rx: Rheumatic heart disease
bed rest
penicillin
aspirin
surgery
