Physiology - Heart Valve Diseases Flashcards

1
Q

What is the New York Heart Association Functional Classification?

A

On how much exercise one can do:
Class I: No limitation
Class II: Slight limitation of ordinary activity
Class III: Marked limitation of less than ordinary activity
Class IV: Severe limitation of minimal activity or at rest. Slide 7

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2
Q

What are the signs of right sided heart failure?

A

Raised JVP
Pitting oedema
Hepatic Congestion. Slide 9

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3
Q

What can possibly happen to the location or appearance of the apex beat?

A

Usually it is in the 5th intercostal space mid clavicular.
However it can become a tapping apex beath in mitral stenosis
Displaced and diffuse in LV dilation
Heaving and displaced in LVH. Slide 12

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4
Q

What would a parasternal heave indicate?

A

Cor Pulmonale

Pulmonary hypertension. Slide 13

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5
Q

What is a cardiac murmer and what are the categories they can be caused by?

A

It is the audible turbulence of blood flow and can be innocent or pathological. Slide 16

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6
Q

What are the steps in describing a murmur?

A
Systole/Diastole
What type of murmur
Where is it loudest
Radiation?
What grade of murmur
Is it influenced by respiration. Slide 18
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7
Q

Which murmur is pansystolic?

A

Mitral regurgitation. Slide 23

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8
Q

Where does mitral regurg and aortic stenosis radiate to?

A

Aortic stenosis - Carotids
Mitral regurg - Axilla
Slide 26

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9
Q

What is the grading of murmers?

A
I: very quiet
II: Quiet and easy to hear
III: Loud
IV: Loud with thrill
V: Very loud with thrill
VI: Loud and audible without a stethoscope. Slide 28
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10
Q

What does RILE stand for?

A

RIGHT sided heart murmurs are louder on INSPIRATION
LEFT sided murmers are louder on EXPIRATION
Slide 30

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11
Q

What are the 3 types of valvular heart disease you can get?

A

Valve stenosis: Not open correctly
Valve regurg: Not close properly
Mixed valve disease: Neither open/close properly
Slide 35

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12
Q

What can the causes of aortic stenosis be?

A

Degenerative
Congenital (bicuspid valve forms instead of tri)
Rheumatic
Slide 38

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13
Q

What are the symptoms/ signs and treatment for Aortic stenosis?

A

Breathlessness, chest pain whcih mimics angina, dizziness.
Low volume pulse, forceful displaced apex.

Conventional valve replacement, TAVI or Balloon aortic valvotomy. Slide 42+43

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14
Q

What are the pros and cons between mechanical and bio-prosthetic heart valves?

A

Mechanical: Last long, have to take warfarin and used in younger patients

Bio-prosthetic: No warfarin but last 10 years and used in older patients. Slide 45

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15
Q

What is a TAVI?

A

Transcatheter Aortic Valve Implantation.Slide 46

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16
Q

What are the possible causes for mitral regurgitation be?

A

Problem with the leaflets
Chordae rupture
Papillary muscles rupture due to ischaemia
Annular dilation Slide 50

17
Q

What are the signs/symptoms and the treatment for mitral regurg?

A

Breathlessness, peripheral oedema, fatigue
Displaced apex and a pansystolic murmur.

Diuretics and heart failure meds.
Surgery
Percutaneous (infants)
Slide 55

18
Q

What are the causes for mitral stenosis?

A

Mainly rheumatic but rarely congenital. Slide 57

19
Q

What are the signs/symptoms, characteristic murmur sound and treatment for mitral stenosis?

A

Breathlessness, palpitations, fatigue
Malar flush, tapping apex and characteristically a mid diastolic rumbling murmur.

Diuretics and treat AF which can be a complication.
Surgery
Balloon valvuloplasty.
Slide 58+62

20
Q

What are the possible causes for aortic regurg?

A

Leaflets damages

Annulus e.g. marfans or aortic dissection. Slide 65

21
Q

What are the signs/symptoms, characteristic murmur sound and treatment for aortic regurg.?

A

Breathlessness
Collapsing pulse, wide pulse pressure, displaced apex and an early diastolic murmur.

ACEI and surgery
Slide 66+69