Patient with Chest Pain and Structural Heart Disease Flashcards

1
Q

Causes of chest pain can range from emergent to benign and it is your job to what?

A

thoroughly investigate to discover what the true etiology is

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2
Q

What is the “BIG 6”

A

1) Acute Myocardial Infarction/Unstable Angina.
2) Pulmonary Embolism (PE)
3) Pericardial Tamponade
4) Esophageal Rupture
5) Tension Pneumothorax/Pneumothorax
6) Aortic Dissection/Rupture

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3
Q

If you can rule out the big 6, you can very likely feel that the patient will survive the next ____.

A

24 hours

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4
Q

Treatment for chest pain…..

What if its one of the big 6?

A

Treat underlying cause

If the diagnosis is one of the big 6, then remember ABCs, IV, O2 if saturation < 94%, Monitor and appropriate treatment, then TRANSFER ASAP

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5
Q

What is the Cardiac valves main job in the body?

A

create one-way flow in the heart

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6
Q

Another name for leaking heart valve. Occurs when blood flows back through the valve as the leaflets are closing, or leaks through the leaflets when they should be completely closed

A

Regurgitation

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7
Q

Is a term for a valve that doesn’t open properly. The flaps of the valve thicken, stiffen, or fuse together. Thus the heart has to work harder to pump blood through the valve

A

Stenosis

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8
Q

What is the most important congenital Structural Heart Disease issue to worry about?

A

congenital bicuspid Aortic valve
can lead to aortic aneurysm formation

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9
Q

what is Mitral Regurgitation

A

Back flow of blood from the left ventricle back into the left atrium during systole

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10
Q

what causes Mitral Regurgitation

A

MI of the papillary muscle
rheumatic heart, disease, endocarditis, dilated cardiomyopathy, and mitral annulus calcification(AGE)

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11
Q

Mitral Regurgitation is commonly caused by what

A

rheumatic heart disease

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12
Q

what is Mitral Valve Prolapse and what is it often referred to as?

A

“floppy” mitral valve

“degenerative” mitral valve disease

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13
Q

how would you hear Mitral Regurgitation

A

Possible S3

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14
Q

how would you hear Mitral Valve Prolapse

A

Mid-Systolic click

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15
Q

Mitral Stenosis is primarily caused by what?

A

rheumatic heart disease

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16
Q

Mitral Stenosis sounds like what on an exam

A

Low pitched DIASTOLIC murmur

17
Q

Aortic Stenosis Usually caused by….

A

by progressive valvular calcification and degeneration
with age > 65.

18
Q

Aortic Stenosis sounds like what

A

Systolic crescendo – decrescendo murmur throughout systole with radiation to the right carotid artery

19
Q

what can you feel during you exam from Aortic Stenosis

A

Parasternal heave
Thrill in the aortic position.

20
Q

What is a thrill?

A

is a vibratory sensation on your hand

21
Q

what is a Heave what does this suggest?

A

an upward push on your hand when you palpate the precordium
suggesting the presence of ventricular hypertrophy

22
Q

What causes blood to flow from the Aorta back into the left ventricle during diastole?

A

Aortic Regurgitation

23
Q

how does Aortic Regurgitation present on a PE

A

1) Soft aortic DIASTOLIC murmur
2) Wide pulse pressure
3) Pulmonary edema

24
Q

what is the gold standard for diagnosis in regards to Structural Heart Disease

A

Echocardiography

25
Q

What is definitive treatment of valvular heart disease

A

Surgical repair is the definitive treatment for valvular heart disease with either tissue or mechanic valve replacement

26
Q

how would you treat Treat valvular heart disease

A

Treat symptomatically

27
Q

Any new murmur must be referred to __, MEDADVICE if asymptomatic, ______ if symptomatic or unstable.

A

MO
MEDEVAC

28
Q

what can you feel during you exam from Aortic Stenosis

A

Parasternal heave
Thrill