Right heart valve disease

Question 1

Tricuspid regurgitation causes

Answer 1

Functional e.g. RV dilatation
Rheumatic fever
IE
Carcinoid syndrome
Congenital e.g. ASD
Drugs (bromocriptine, cabergoline, fenfluramine)

Question 2

Tricuspid regurgitation symptoms

Answer 2

Fatigue
Hepatic pain on exertion (hepatic congestion)
Oedema

Question 3

Tricuspid regurgitation signs

Answer 3

Giant v waves and prominent y descent in JVP
RV heave
Pansystolic murmur heard at lower sternal edge in inspiration
Pulsatile hepatomegaly

Question 4

Tricuspid regurgitation management

Answer 4

Treat underlying cause
Diuretics for congestion
Valve repair/replacement if needed

Question 5

Tricuspid stenosis causes

Answer 5

Mainly rheumatic fever

Also congenital or IE

Question 6

Tricuspid stenosis symptoms

Answer 6

Fatigue
Ascites
Oedema

Question 7

Tricuspid stenosis signs

Answer 7

Giant a wave + slow y descent in JVP
Early diastolic murmur heard at left sternal edge in inspiration
AF can occur

Question 8

Tricuspid stenosis diagnosis

Answer 8

Echo

Question 9

Tricuspid stenosis management

Answer 9

Diuretics

Surgical repair

Question 10

Pulmonary stenosis causes

Answer 10

Mostly congenital
Rheumatic fever
Carcinoid syndrome

Question 11

Pulmonary stenosis symptoms

Answer 11

Dyspnoea
Fatigue
Oedema
Ascites

Question 12

Pulmonary stenosis signs

Answer 12

Congenital signs
Prominent a wave in JVP
Ejection systolic murmur which radiates to left shoulder , softer P2

Question 13

Pulmonary stenosis ECG

Answer 13

RAD
p-pulmonale
RVH
RBBB

Question 14

Pulmonary stenosis tests

Answer 14

ECG
CXR shows prominent pulmonary arteries
Cardiac catheterisation diagnostic

Question 15

Pulmonary stenosis management

Answer 15

Pulmonary valvuloplasty/ valvotomy

Question 16

Pulmonary regurgitation causes

Answer 16

Any pulmonary HT cause

Question 17

Pulmonary regurgitation signs

Answer 17

Descrescendo murmur in early diastole at left sternal edge

Graham Steell murmur if associated with mitral stenosis