OME/cardio/Valves Flashcards
Cause of Murmurs
Increased Turbulence due to narrowed lumen
Murmurs are confirmed by using
Echocardiogram
Murmurs are treated only if the are…
> grade 3, symptomatic, and diastolic
Determine murmur grades
Grade 1. S1/S2 louder than murmur
- S1/S2= to murmur
- Murmur>S1/S2
- Palpable/thrill
- Heard with stethoscope off chest
S1/S2 caused by
S1- closing of mitral/tricsupid valves
S2-Aorta/pulmonary
Mitral valve best heard at
Apex 5th intercostal space mid-clavicular line
Mitral stenosis best heard during
diastole
Mitral stenosis causes…
Which may lead to….
build up within atrium
Afib
Signs/Symptoms of mitral stenosis..
Similar to Lft side CHF
Common cause of mitral stenosis
Rheumatic fever
Auscultation of mitral stenosis sounds like
open snap with decrescendo murmur
Degree of stenosis is based on
how early the snap is
Treatment for mitral stenosis
1st-balloon plasty/valvotomy (due to possibility of Afib)
2nd-Valve replacement possible but, may mean additional replacements in future for younger pts.
Aortic Stenosis best heard where
upper right 2nd intercostal space
All, physicians, take, money
Aortic Stenosis sounds like
crescendo-decresendo
Aortic Stenosis best heard during
Systole
Common cause of Aortic Stenosis
calcification (Elderly pts) Bicuspid valve accelerates calcification (earlier onset)
Common sign/symptom of Aortic Stenosis
Angina/syncope with exertion (increased O2 demand and decreased supply)
Aortic Stenosis results in
excess blood with ventricles->floppy/dilated heart->CHF
Treatment for Aortic Stenosis
1st-Preload reduction(diuretics-less to push)
2nd- Valve replacement with CABG (Coronary artery bypass graft)(replacement->lose of osia-openning- above valve for coronary artery)
Effect of Mitral valve regurgitation on blood flow
1-Decreases forward flow
2-Increases back flow
Mitral valve regurgitation is commonly due to?
1-MI-> ruptured papillary muscle and/or chordae tendineae
2-Mitral valve prolapse from valves that dont sit in annulus properly
3-Infective endocarditis
Mitral valve regurgitation common in?
Pregnant women
Mitral valve prolapse can be treated by?
Increasing volume so valves fit better (Beta-Blockers)
Tx of Mitral valve regurgitation not due to prolapse?
Volume reduction
Fibrillation vs flutter
Fib: fast pace (irregular) and Irregular beat (Interval)
Flutter: faster pace with regular beat
Mitral valve regurgitation sound described as?
Holosystolic murmur radiating to axilla (armpit)
Aortic insufficiency heard during?
Diastole
2 common causes of Aortic insufficiency
MI and Infection
increased volume in right atrium can–>
Stretch-> Afib and CHF like symptoms.
Decreased forward flow–>
dilated ventricle and carcinogenic shock
Aortic insufficiency sound described as?
Decrescendo
2 valve conditions that cause increased preload
1-Hypertrophic Obstructive Cardiomyopathy
2-Mitral Valve Prolapse
2 Maneuvers to increase preload
Squats and leg lift
2 Maneuvers to increase after-load
Valsalva and hand squeeze
Which two valve conditions worsens with increased afterload
1-Hypertrophic Obstructive Cardiomyopathy
2-Mitral Valve Prolapse
Sudden death in a athletic young person think
Hypertrophic Obstructive Cardiomyopathy (obstructs aortic outflow)
