OnlineMedEd: Cardiology - "Valvular Disease" Flashcards

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1
Q

Review the murmur grading system.

A
  • I: S1 and S2 are louder than the murmur
  • II: S1 and S2 are equal to the murmur
  • III: S1 and S2 are softer than the murmur
  • IV: III criteria plus a palpable thrill
  • V: being able to hear the murmur with the stethoscope half off the chest
  • VI: hearing the murmur without a stethoscope
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2
Q

What murmurs need to be worked up?

A
  • Systolic murmurs greater than II/VI intensity

* Any diastolic murmur

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3
Q

Murmurs that need to be worked up should be evaluated with _______________.

A

echocardiography

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4
Q

Mitral stenosis leads to what blood flow abnormality?

A

Pulmonary edema

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5
Q

Patients with mitral stenosis often present with two other cardiac disorders: ______________.

A

CHF or atrial fibrillation

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6
Q

Mitral stenosis causes what murmur?

A

Rumbling diastolic murmur with an opening snap that radiates to the axilla

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7
Q

Why is the first-line treatment for mitral stenosis balloon valvuloplasty?

A

Patients with mitral stenosis are usually much younger than other valvular patients, and artificial valves don’t last very long. Valve replacement requires sternotomies, and you want to avoid repeat sternotomies in a young person.

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8
Q

Discuss the different presentations of acute and chronic aortic insufficiency.

A

• Acute (often caused by aortic dissection):

  • Cardiogenic shock
  • Sudden pulmonary edema
  • Chest pain

•Chronic:
- CHF

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9
Q

Aortic insufficiency results in what murmur?

A

Early diastolic decrescendo murmur heard over the base of the heart

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10
Q

The only treatment for aortic insufficiency is _______________.

A

valve replacement

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11
Q

The two etiologies of mitral insufficiency are _______________.

A

infection and infarction

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12
Q

The acute and chronic presentations of mitral insufficiency are very similar to _______________.

A

aortic insufficiency: acute (cardiogenic shock and flash pulmonary edema) and chronic (CHF and atrial fibrillation)

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13
Q

People with HOCM typically have mutations in _____________.

A

the sarcomere

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14
Q

HOCM and aortic stenosis both present with systolic ejection murmurs. How can you differentiate the two?

A

The murmur of AS increases with increased preload, while that of HOCM decreases with increased preload.

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15
Q

Like HOCM, the treatment for ______________ also entails beta-blockade and avoidance of dehydration.

A

mitral valve prolapse

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