Valve Disease

Question 1

Signs of RHF

Answer 1

Elevated JVP
Hepatic congestion
Pitting oedema

Question 2

NY Heart Association Functional Classification (NYHA)

Answer 2

Class I - No limitation
•Class II - Slight limitation of ordinary activity
•Class III - Marked limitation of less than ordinary activity
•Class IV - Severe limitation of minimal activity or at rest

Question 3

Cardiac breathlessness associated with

Answer 3

Ankle oedema
Orthopnoea (ask about pillows)
PND

Question 4

What does a parasternal heave indicate?

Answer 4

Right ventricular overload

Cor pulmonale/pulmonary hypertension

Question 5

What causes murmurs? (2 kinds)

Answer 5

Innocent - Increased blood flow

Patho - structural abnormalities

Question 6

Signs of aortic stenosis

Answer 6

Dyspnoea, angina, syncope

Question 7

What causes aortic stenosis?

Answer 7

Degenerative, congenital (bicuspid valve), rheumatic HD

Question 8

Causes of Mitral regurgitation

Answer 8

Leaflets
•Prolapse
•Rheumatic
•Myxomatous (floppy)
•Endocarditis

Chordae rupture (degenerative)
•Prolapse/flail leaflet

Papillary muscles rupture
•Ischaemic

Annular dilatation
•Function

Question 9

Treatment for mitral regurgitation

Answer 9

Diuretics and heart failure (ACE inhibitors)
•Surgical
•Repair – prolapse
•Replacement - degenerative
•Percutaneous
•Clips in infancy – encouraging results