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Finals > Murmurs and valvular pathology > Flashcards

Murmurs and valvular pathology Flashcards

1
Q

Aortic area

A
  • 2nd ICS
  • Right sternal border
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2
Q

Pulmonary area

A
  • 2nd ICS
  • Left sternal border
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3
Q

Erb’s point

A
  • 3rd ICS
  • Left sternal border
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4
Q

Tricuspid area

A
  • 5th ICS
  • Left sternal border
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5
Q

Mitral area

A
  • 5th ICS space
  • Midclavicular line
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6
Q

what valvular pathology cause left atrial hypertrophy and why

A
  • Mitral stenosis
  • Pushing against a stenosed valve is what cause hypertrophy
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7
Q

What valvular pathology causes LV hypertrophy

A

Aortic stenosis

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8
Q

what valular pathology would cause LA dilation and why ?

A

Mitral regurgitation : a leaky valve allows blood to flow back into a chamber causing it too thin and dilate

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9
Q

What valular pathology would cause LV dilatation

A

Aortic regurgitation

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10
Q

Describe the murmur heard in AS

A
  • Ejection systolic
  • High pitched
  • Crescendo descendo
  • Heard loudest in the aortic area
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11
Q

3 causes of AS

A
  1. Idiopathic age related calcification (most common) >65yrs
  2. Rheumatic disease
  3. Bicuspid aortic valve <65 ys
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12
Q

Radiation of murmur in AS

A

Carotids

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13
Q

3 other signs of AS

A
  • Slow rising pulse
  • Narrow pulse pressure
  • Soft / absent S2
  • S4
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14
Q

3 signs of severe AS

A

S : syncope (exertional)
A : angina
D : dyspnoea

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15
Q

Treatment of severe AS in pts high risk for open aortic valve replacement

A

Transcatheter aortic valve implantation

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16
Q

why can the apex be displaced in AS?

A

Due to LV hypertrophy caused by trying to push blood against a stenosed valve

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17
Q

what 3 Ix would you do in AS and why ?

A
  1. Echo - diagnostic
  2. ECG - LV hypertophy
  3. CXR - cardiomegaly
18
Q

when is valvular replacement consider for AS

A
  1. Symptomatic
  2. Asymptomatic but with valvular gradient >40mmHg and with features such as LV systolic dysfunction
19
Q

Murmur heard in aortic regurgitation and how is the intensity of the murmur increased

A

Early diastolic murmur
Handgrip manoeuvre

20
Q

2 other features of aortic regurgitation

A

Collapsing pulse
wide pulse pressure

21
Q

2 signs elicited in aortic regurgitation

A
  1. Quincke’s sign (nailbed pulsation).
  2. De Musset’s sign (head bobbing)
22
Q

Further murmur heard in aortic regurgitation and why

A

Mid diastolic austin flint murmur if severe -> vibrating of mitral valve as blood flows back over it

23
Q

Causes of AR due to valve disease and common acute presentation

A
  1. Rheumatic fever
  2. Calcific disease
  3. Connective tissue disease (RA/SLE)

Infective endocarditits

24
Q

Murmur heard in mitral stenosis

A

Mid-late diastolic murmur
Best heard on inspiration

25
Q

Other features heard in mitral stenosis

A
  • Loud S1
  • Opening snap : indicates valve leaflets are still mobile
26
Q

Symptoms seen in mitral stenosis

A

SOB
Haemoptysis
Malar flush

27
Q

Findings on CXR in MS

A

LA enlargement

28
Q

Likely underlying valve disease if AF and mid-late diastolic murmur

A

Mitral stenosis

29
Q

Most common cause of mitral stenosis

A

Rheumatic fever

30
Q

Describe the murmur heard in Mr

A

Blowing pansystolic murmu
Heard best at the apex
Radiates to the axilla

31
Q

what may be seen on ECG in MR

A

Broad P wave, indicative of atrial enlargement

32
Q

What may be seen on CXR in MR

A

Cardiomegaly due to LA enlargment

33
Q

Ejection systolic murmur

A
  • AS
  • Hypertrophic obstructive cardiomyopathy
  • Pulmonary stenosis
  • ASD
  • TOF
34
Q

Pansystolic murmur

A
  • Mitral regurg
  • Tricuspid regurg
  • VSD
35
Q

Early diastolic

A

Aortic regurg (high pitched and blowing)

36
Q

Mid - late diastolic

A

Mitral stenosis (rumbling)

37
Q

Continuous machinery like

A

PDA

38
Q

Ejection systolic louder on expiration

A

Aortic stenosis or hypertrophic obstructive cardiomyopathy

39
Q

Ejection systolic louder on inspiration

A

Pulmonary stenosis
ASD

40
Q

Pansystolic, louder on inspiration

A

Tricuspid regurgitation

41
Q
A

Finals (92 decks)

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