T3 L4: Valvular heart dysfunction Flashcards
What are murmers?
Sounds between diastole and systole
What does a midsystolic murmer indicate?
Aortic stenosis, pulmonic stenosis, atrial septal defect or hypertrophic obstructive cardiomyopathy (HOCM)
What does a holosystolic (throughout systole) murmur indicate?
Mitral regurgitation, tricuspid regurgitation or a ventricular septal defect
What does a late systolic murmer indicate?
A mitral valve prolapse
What is a valve prolapse?
When the valve doesn’t close smoothly or evenly often caused by overly stretchy valve leaflets
What does a diastolic murmer indicate?
Aortic regurgitation, pulmonic regurgitation or austin-flint
What is an austin-flint?
A murmer heard best at the apex of the heart. It can be indicative of severe aortic regurgitation
What does a mid/late diastolic murmer indicate?
Mitral or tricuspid stenosis
What is patent ductus arteriosus?
A condition when the ductus arteriosus fails to close and this will cause murmers
When is the ‘lub’ sound heard?
S1, when the tricuspid and mitral valves close (beginning of systole)
When is the ‘dub’ sound heard?
S2, when the aortic and pulmonary valves close ( end of systole/beginning of diastole)
What is degenerative valve disease and what causes it?
When the valves fail to close properly because there’s a build up of calcification deposits
Who is most likely to develop degenerative valve disease?
The aging population. The calcification deposits build up over time
What causes rheumatic valve disease?
Post streptococcal rheumatic fever. Its a disease of poverty and overcrowding because in a developed community, the disease will be treated before the valve disease develops
What is rheumatic fever and what causes it?
Streptococcus group A. It develops after a throat infection or scarlet fever
Who is most likely to develop valvular disease caused by infection?
Those with ‘abnormal’ valves to begin with and the immunocompromised
Which valve does rheumatic valve disease mostly affect and why?
The mitral valve because
What is the SAD triad and what does it stand for?
A feature of severe aortic stenosis (Syncope, Angina, and Dyspnoea)
Why does aortic stenosis cause left ventricular hypertrophy?
Because the blood fails to leave the left ventricle because the aortic valve isn’t opening enough so pressure builds up
What happens in systole compared to diastole?
Blood flows out during systole and flows in during diastole
Why does a quite murmur indicate higher severity of stenosis?
A quieter murmur indicates less turbulence but that means that the valve is opening less
What does CREAM stand for with regards to aortic regurgitation?
Congenital Rheumatic damage Endocarditis Aortic distention caused by high pressure Marfan's disease
Its the causes of the regurgitation
Why does aortic regurgitation cause volume overload?
Because blood isn’t leaving the heart properly
When would a murmur be heard with aortic regurgitation?
During early diastole because that when the blood flows
What causes papillary muscle failure?
Ischaemia because it causes the muscles to stop working properly
When would murmurs be heard with mitral regurgitation?
Throughout systole
What is the main cause of mitral stenosis?
Rheumatic disease
When would a mitral stenosis murmur be heard?
Mid-diastole as stenosis restricts blood flow across the mitral valve
What is the gold standard diagnosis for valvular disease?
An echocardiography
What are the 2 types of valves given as replacement?
Mechanical and biological
What is patent ductus arteriosus?
When the ductus arteriosus doesn’t close before birth
What causes cor-pulminarle?
The high pressure in the right ventricle and lungs that causes the right heart to fail
