murmur Flashcards

1
Q

symptoms of aortic stenosis

A

chest pain, SOB, syncope (esp on exercise)

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2
Q

what type of murmur is aortic stenosis

A

ejection systolic - radiates to carotids

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3
Q

what manouvre decreases aortic stenosis

A

valsava

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4
Q

features of severe aortic stenosis (5)

A

narrow pulse pressure // slow rising pulse // soft or absent S2 // S4 // thrill // LV hypertrophy

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5
Q

causes of aortic stenosis (5)

A

calcification // bicuspid aortic valve // williams syndrome // post-rhemuatic // HOCM

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6
Q

most common cause of aortic stenosis in 65+

A

calcification

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7
Q

most common cause of aortic stenosis in <65

A

bicuspid aortic valve

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8
Q

what is treatment for asymptomatic aortic stenosis

A

observe

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9
Q

what feature of asymptomatic aortic stenosis may warrent treatment

A

valvular gradient >40 mmHg + features of LV systolic dysfunction

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10
Q

mx for aortic stenosis

A

surgical valve replacement in fit patients // catheter in unwell // (balloon children)

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11
Q

most common murmur

A

aortic stenosis

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12
Q

RF mitral regurg

A

female, low BMI, age, renal dsyfunction, previous MI, previous mitral disease, collagen disorder

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13
Q

causes of mitral regurg (5)

A

following coronary artery disease or post MI // mitral valve prolapse // endocarditis // rheumatic fever // congenital

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14
Q

murmur of mitral regurg

A

panysystolic ‘blowing’ // loudest in apex // S1 quiet, S2 may split

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15
Q

ECG mitral regurg

A

broad p wave

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16
Q

imaging for mitral regurg

A

CXR: cardiomegaly // echo

17
Q

medical mx mitral regurg (5)

A

nitrates // diuretics // positive inotropes // balloon pump // ACEi for HF

18
Q

surgery for mitral regurg

A

1st = repaire // 2nd = artificial or pig

19
Q

causes mitral stenosis

A

RHEUMATIC FEVER

20
Q

symptoms mitral stenosis (5)

A

SOB // haemoptysis // malar flush (in cheeks) // Afib // weak pulse

21
Q

murmur mitral stenosis

A

mid diastolic (expiration) // loud S1 (snap)

22
Q

severe murmur MS

A

increased length // opening snap becomes closer to S2

23
Q

imaging mitral stenosis

A

CXR = LA enlarged // echo

24
Q

mx for mitral stenosis with AF

25
mx asymptomatic mitral stenosis
monitor + echos
26
mx symptomatic mitral stenosis
surgery - balloon or replacement
27
what causes valve disease --> aortic regurg
rheumatic fever! // calcified / endocarditis // bicuspid valve // SLE or RA
28
what causes aortic root disease --> aortic regurg
marfans or EDS // bicuspid aortic valve // dissection // hypertension // syphilis
29
murmur aortic regurg
early diastolic
30
signs aortic regurg
wide pulse pressure // collapsing pulse // quinckes sign (nailbed pulse) // De Musset's sign (head bobbing)
31
invx aortic regurg
echo
32
mx aortic regurg
(mx for HF) // surgery if severe
33
what causes tricuspid regurg
RV infarction // COPD // rheumatic heart // endocarditis (IVDU)
34
murmur tricuspid regurg
pansystolic // JVP // pulsatile hepatomegaly // left parasternal heave
35
what can cause mitral valve prolapse
congenital heart disease // cardiomyopathy // Turners, marfans, fragile X // polycystic kidneys // WPW
36
symptoms mitral valve prolapse
paliptations // mid systolic click (squatting) // late systolic click (standing)
37
biggest con of biological heart valve
degeneration
38
what medication given for biological heart valves
aspirin long term // no need for anticoag (maybe warfarin 3 months)
39
biggest con mechanical valve
thrombosis and life long coag