Salman (cm valvular diseases)

Question 1

Radial Pulse - Collapsing Pulse

Answer 1

Associated with Aortic Regurgitation (AR)

Question 2

Radial Pulse - Weak Slow Rising Pulse

Answer 2

Associated with Aortic Stenosis (AS)

Question 3

Radial Pulse - Irregularly Irregular Pulse

Answer 3

Associated with Mitral Stenosis (MS)

Question 4

Jerky Dancing Carotid Pulse (Corrigan Sign)

Answer 4

Associated with Aortic Regurgitation (AR)

Question 5

Slow Rising Carotid Pulse

Answer 5

Associated with Aortic Stenosis (AS)

Question 6

Heaving Apex Beat

Answer 6

Indicates Hypertrophy in Aortic Stenosis (AS)

Question 7

Hyperdynamic Displaced Apex Beat

Answer 7

Indicates Dilation in Aortic Regurgitation (AR) and Mitral Regurgitation (MR)

Question 8

Systolic Murmur in AS

Answer 8

Ejection systolic murmur

Question 9

Early Diastolic Murmur in AR

Answer 9

Indicates Aortic Regurgitation (AR)

Question 10

Mid-Diastolic Murmur in MS

Answer 10

Indicates Mitral Stenosis (MS)

Question 11

Pansystolic Murmur in MR

Answer 11

Indicates Mitral Regurgitation (MR)

Question 12

Mid-End Systolic Click

Answer 12

Indicates Mitral Valve Prolapse (MVP)

Question 13

Definition of Mitral Regurgitation

Answer 13

Backflow of blood from the left ventricle to the left atrium due to improper closure of the mitral valve

Question 14

Volume Overload in Ventricles & Atrium

Answer 14

Leads to dilation and heart failure

Question 15

Causes of Mitral Regurgitation

Answer 15

Myocardial infarction, infective endocarditis, mitral valve prolapse

Question 16

Myocardial Infarction and MR

Answer 16

Ruptured papillary muscle causing mitral regurgitation

Question 17

Infective Endocarditis and MR

Answer 17

Ruptured chordae tendineae causing mitral regurgitation

Question 18

Mitral Valve Prolapse and MR

Answer 18

Myxomatous degeneration leading to mitral regurgitation

Question 19

Symptoms of MR

Answer 19

Palpitations, exertional dyspnea, sudden dyspnea in acute cases

Question 20

Signs of MR

Answer 20

Soft S1, pansystolic murmur, hyperdynamic & displaced apex beat, S3 sound, pulmonary hypertension

Question 21

Diagnosis of MR

Answer 21

Chest X-ray (LV & LA dilation), echocardiogram

Question 22

Complications of MR

Answer 22

Left heart failure, pulmonary hypertension, right ventricular hypertrophy

Question 23

Treatment of MR

Answer 23

Diuretics, ACE inhibitors, mitral valve repair or replacement

Question 24

Indications for Valve Replacement in MR

Answer 24

Symptomatic patients or asymptomatic patients with specific echocardiographic findings

Question 25

Definition of Mitral Stenosis

Answer 25

Narrowing of the mitral valve opening, increasing pressure in the left atrium

Question 26

Normal Mitral Valve Area

Answer 26

4-6 cm²

Question 27

Severe Mitral Stenosis Valve Area

Answer 27

<1 cm²

Question 28

Primary Cause of Mitral Stenosis

Answer 28

Rheumatic heart disease

Question 29

Pathophysiology of Mitral Stenosis

Answer 29

Increased left atrial pressure, pulmonary edema, pulmonary hypertension, right ventricular hypertrophy

Question 30

Common Complication

Answer 30

Atrial fibrillation due to increased left atrial pressure

Question 31

Symptoms of Mitral Stenosis

Answer 31

Exertional dyspnea, stroke symptoms if atrial fibrillation occurs

Question 32

Signs of Mitral Stenosis

Answer 32

Irregularly irregular pulse, tapping apex beat, loud S1, opening snap, mid-diastolic murmur

Question 33

Diagnosis of Mitral Stenosis

Answer 33

ECG, chest X-ray, echocardiogram

Question 34

Complications of Mitral Stenosis

Answer 34

Stroke (due to atrial fibrillation), pulmonary hypertension, right heart failure

Question 35

Treatment of Mitral Stenosis

Answer 35

Warfarin and beta-blockers if atrial fibrillation, diuretics for dyspnea, definitive treatment via percutaneous balloon mitral valvuloplasty (PBMV) or mitral valve replacement

Question 36

Indications of Severe Mitral Stenosis

Answer 36

Short interval between opening snap and S2 sound

Question 37

Definition of Aortic Stenosis

Answer 37

Narrowing of the aortic valve, increasing pressure in the left ventricle

Question 38

Primary Causes of Aortic Stenosis

Answer 38

Calcification of the aortic valve (elderly), congenital bicuspid valve, rheumatic fever

Question 39

Pathophysiology of Aortic Stenosis

Answer 39

Increased left ventricular pressure leading to hypertrophy, eventual heart failure and ischemia

Question 40

Risk Factors for Calcified Aortic Stenosis

Answer 40

Hypertension, diabetes, smoking, high cholesterol

Question 41

Symptoms of Aortic Stenosis

Answer 41

Angina, syncope, pulmonary edema

Question 42

Signs of Aortic Stenosis

Answer 42

Slow-rising and late-peaking carotid pulse, heaving apex beat, mid-systolic crescendo-decrescendo murmur radiating to carotids, absent or paradoxically split S2

Question 43

Diagnosis of Aortic Stenosis

Answer 43

Chest X-ray (LV hypertrophy), ECG (LV hypertrophy), echocardiogram, cardiac catheterization

Question 44

Treatment of Asymptomatic Aortic Stenosis

Answer 44

Annual serial echocardiograms

Question 45

Treatment of Symptomatic Aortic Stenosis

Answer 45

Aortic valve replacement

Question 46

Complications of Aortic Stenosis

Answer 46

Left heart failure, ventricular fibrillation

Question 47

A:Syncope in Elderly

Answer 47

Usually due to Aortic Stenosis

Question 48

A: Syncope in Young

Answer 48

Usually due to vasovagal attack

Question 49

Definition of Aortic Regurgitation

Answer 49

Backflow of blood from the aorta into the left ventricle due to improper closure of the aortic valve

Question 50

Primary Causes of Aortic Regurgitation

Answer 50

Marfan syndrome, ankylosing spondylitis, infective endocarditis, aortic dissection

Question 51

Pathophysiology of Aortic Regurgitation

Answer 51

Increased volume load on the left ventricle leading to dilation and hyperdynamic displaced apex, heart failure at a later stage

Question 52

Characteristic Pulse of Aortic Regurgitation

Answer 52

Collapsing pulse (Corrigan's sign)

Question 53

Symptoms of Aortic Regurgitation

Answer 53

Shortness of breath, palpitations

Question 54

Signs of Aortic Regurgitation

Answer 54

Collapsing pulse, jerky carotid pulse (Corrigan's sign), hyperdynamic apex beat, early diastolic murmur

Question 55

Diagnosis of Aortic Regurgitation

Answer 55

Chest X-ray (LV enlargement), ECG, echocardiogram

Question 56

Treatment for Asymptomatic Aortic Regurgitation

Answer 56

Annual serial echocardiograms (every 6 months if severe)

Question 57

Treatment for Asymptomatic Aortic Regurgitation with Marfan Syndrome

Answer 57

Beta-blockers

Question 58

Treatment for Symptomatic Aortic Regurgitation

Answer 58

Aortic valve replacement

Question 59

Treatment for Left Heart Failure in Aortic Regurgitation

Answer 59

ACE inhibitors