Valve Disease

Question 1

S4 - S1 - S2 - OS - S3 describes which type of valve disease?

Answer 1

Mitral stenosis

Question 2

A pt presents with pulmonary HTN, RV failure, tachycardia, and pulmonary edema. On exam you hear a diastolic murmur in the mitral area. What valve disease do you suspect? How do you treat it?

Answer 2

Severe Mitral Stenosis
Control HR
Surgery (percutaneous valvuloplasty, open replacement)

Question 3

A pt presents with an opening snap after S2. You hear a diastolic murmur in the mitral area, but the pt is asymptomatic. What is the MC cause of the pt’s condition? Describe the pathology behind his condition.

Answer 3

Mitral Stenosis
Rheumatic fever (MC)
Mitral valve calcification --> decreased atrial outflow --> high atrial P --> backflow into pulm circulation --> lymph system can't drain fluid

Question 4

If a pt has mitral stenosis and is currently in A-Fib, how do you treat this pt?

Answer 4

Warfarin

Question 5

Which valve disease causes a pansystolic murmur at the apex that radiates to the axilla? What compplication are you worried about?

Answer 5

Mitral regurgitation
LV failure (d/t low CO)

Question 6

A pt presents with a systolic murmur in the mitral area. You suspect he has mitral regurg. What is the underlying pathology of his disease?

Answer 6

Papillary muscle failure/dysfunction

Enlarged mitral annulus

Question 7

A pt presents with a pansystolic murmur at the apex that radiates out to her axilla. Echo shows systolic back-flow into the LA. How do you treat this pt is she is asymptomatic? If she is symptomatic If she has a low CO?

Answer 7

Mitral Regrugitation
Asymptomatic - no Tx
Symptomatic - treat sx
Decreased CO - valve repair

Question 8

Your pt has a history of mitral regurg which has always been asymptomatic. Next month she is getting her wisdom teeth out and wants to know if she needs to take Abx before the procedure. What should you tell her?

Answer 8

Mitral regurg doesn’t require prophylaxis prior to dental procedures

Question 9

A 52 yo female presents with mid-systolic clicks.She has a history of Marfan’s Dz. CXR shows a “floppy heart”. What diagnosis do you suspect? What else can cause this Dz?

Answer 9

Mitral valve prolapse
Hperadrenergic state
Connective tissue Dz (Marfan, Ehler-Danois)
Chordae rupture

Question 10

A pt presents with mid-systolic clicks and a “floppy heart” on Echo. Lab results show she is in a hyperadrenergic state. What treatment do you recommend?

Answer 10

Mitral Valve Prolapse

B-blockers