TS/TR

Question 1

When do you perform surgery with TS?

Answer 1

If other cardiac surgery is needed

Question 2

What is diagnostic for TS if Echo is unavailable?

Answer 2

RAE, w/out RVH but w/ S/S of RHF

Question 3

What can be seen on EKG w/ TR?

Answer 3

RAE
RVH
A-fib

Question 4

What is heard w/ TR?

Answer 4

Blowing holosystolic murmur heard at LLSB w/ diaphragm

Question 5

When is surgery considered for TR?

Answer 5

If it is severe (valve replacement)

Question 6

How do you TXT TR?

Answer 6

TXT underlying cause

DIuretics for volume overload/congestion

Question 7

Important PE findings of TR?

Answer 7

RV heave

Pulsatile liver edge

Question 8

What tests can be helpful w/ TS?

Answer 8

EKG, CXR, Echo

Question 9

How does TR occur in RHD?

Answer 9

MS causes pulmonary HTN resulting in RVH pulling TV apart.

Question 10

What is an increased risk of TR? Why?

Answer 10

A-Fib, RV regurgitating into RA

Question 11

How is isolated TR tolerated?

Answer 11

Well tolerated by patient

Question 12

What congenital anomaly is associated with TR?

Answer 12

Epstein anomaly

Question 13

What happens to JVP wave form w/ TR?

Answer 13

Prominent “V” waves

Question 14

TS pathophys

Answer 14

TS >
Increases RA pressure >
Fixed CO from RV >
RA dilation >
RHF

Question 15

What causes HF in TS?

Answer 15

Pressure overload

Question 16

How do you treat TS?

Answer 16

Diuretics

Question 17

What test is diagnostic for TR?

Answer 17

Echo

Question 18

What does TS sound like?

Answer 18

Low pitch, diastolic rumble heard at LLSB w/ bell

Question 19

TR pathophys

Answer 19

RA dilation >
RVH >
HF >

Question 20

What are palpitations due to in TS?

Answer 20

Dilated atria - a-fib

Question 21

What are S/S of TS?

Answer 21

Systemic venous congestion S/S
Fatigue
Distended JVP
Palpitations

Question 22

What sounds similar to TS and why?

Answer 22

MS - opening snap

Question 23

What increases TS sound?

Answer 23

Increased preload
Leg raise
Inspiration
Squatting

Question 24

What is seen on an EKG with TS?

Answer 24

RAE w/out RVH but with S/S of RHF

Question 25

RAE w/out RVH but w/ S/S of RHF indicates?

Answer 25

TS

Question 26

What test is diagnostic for TS?

Answer 26

Echo

Question 27

What tests can be used to DX TR?

Answer 27

EKG, CXR, Echo

Question 28

Is TR a functional issue or a structural issue? Why?

Answer 28

Functional

TV pulled apart - Dilated RA/RV due pressure/volume overload

Question 29

What intensifies/diminishes TR?

Answer 29

Inspiration increases

Valsalva or standing decreases

Question 30

Severe TR can cause what to the patient?

Answer 30

Cachectic or chronically ill

Question 31

TS occurs most commonly with what?

Answer 31

Other valvular lesions such as MS in RHD

Question 32

What happens to JVP waveform with TS?

Answer 32

Giant “A” waves

Question 33

What can be seen on CXR w/ TR?

Answer 33

RAE

RVH

Question 34

What is seen on an CXR with TS?

Answer 34

RAE