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Y1 CARDIOLOGY > Valve Disease > Flashcards

Valve Disease Flashcards

1
Q

What is a cardiac murmur?

A

Noise due to turbulent blood flow within the heart

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2
Q

Diastolic murmurs are in time with the carotid pulse. True/False?

A

False

Systolic murmurs are in time with the carotid pulse

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3
Q

What are the 5 steps for describing murmurs?

A 
Systole or diastole?
Which type of murmur?
Where is it best heard?
Does it radiate?
What is the grade?
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4
Q

Where do aortic murmurs tend (but not always) radiate to?

A

Carotids

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5
Q

Where do mitral murmurs tend (but not always) radiate to?

A

Axilla

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6
Q

Where do tricuspid murmurs tend to radiate?

A

Nowhere!

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7
Q

What is a thrill?

A

Palpable murmur

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8
Q

What is a heave?

A

Palpable sensation due to ventricular stress/hypertrophy

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9
Q

Which murmurs, left or right sided, are louder on inspiration?

A

Right sided

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10
Q

Name the main non-invasive investigation for diagnosing cardiac murmurs

A

Echocardiography

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11
Q

Name an invasive investigation for diagnosing cardiac murmurs

A

Cardiac catheterisation

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12
Q

What are the main causes of aortic stenosis?

A

Congenital bicuspid valve
Degeneration/calcification with age
Rheumatic disease

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13
Q

Can aortic stenosis patients be asymptomatic?

A

Yes

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14
Q

What are some symptoms of aortic stenosis?

A

Breathlessness
Chest pain
Dizziness[less cardiac output]

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15
Q

What are some signs of aortic stenosis?

A

Slow-rising pulse
Heaving apex
Ejection systolic
Radiates to carotid

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16
Q

Name some treatment for aortic stenosis

A

Valve replacement
Balloon valvotomy
TAVI (valve implantation)

17
Q

What are the main causes of mitral regurgitation?

A

Rheumatic disease
Myxoma in younger people
Endocarditis
Chorda rupture

18
Q

What are some signs of mitral regurgitation?

A

Displaced apex
Pansystolic
Radiates to axilla

19
Q

Name some treatment for mitral regurgitation

A

Valve replacement

Diuretics, ACEi

20
Q

What is the main cause of mitral stenosis?

A

Rheumatic disease

21
Q

What are some symptoms of mitral stenosis?

A

Breathlessness
Palpitations
Fatigue

22
Q

What are some signs of mitral stenosis?

A

Malar flush
Tapping apex
Mid-diastolic rumbling

23
Q

Name some treatment for mitral stenosis

A

Valve replacement
Balloon valvuloplasty
Diuretics, B blocker, digoxin

24
Q

What are the main causes of aortic regurgitation?

A

Endocarditis
Connective tissue disorders (SLE, rheumatoid)
Marfan’s syndrome

25
Q

What are some symptoms and signs of aortic regurgitation?

A 
SOB
Collapsing pulse
Displaced apex
Early diastolic
Wide pulse pressure
26
Q

What does the 1st heart sound represent?

A

Closure of mitral and tricuspid valves

Beginning of systole

27
Q

What does the 2nd heart sound represent?

A

Closure of aortic and pulmonary valves

End of systole, beginning of diastole

28
Q

Is splitting of the 2nd heart sound physiological?

A

Only during inspiration - reduced intrathoracic pressure which increases venous return to the right side of the heart = prolonged ventricular ejection time

29
Q

Is a 3rd heart sound physiological?

A

Only in healthy young adults - represents acceleration and de-acceleration of blood during early passive filling of the ventricle

30
Q

Is a 4th heart sound physiological?

A

No - refer for ECHO. Represents atrial contraction and rapid blood flow into a less compliant ventricle

31
Q

What are some causes of an innocent heart murmur?

A

Fever
Thyrotoxicosis
Pregnancy
Anaemia

32
Q

Innocent cardiac murmurs are always…

A

Systolic

33
Q

Which murmurs are described as systolic?

A

Aortic stenosis and mitral regurgitation - occur in time with 1st heart sound and carotid pulse

34
Q

Which murmurs are described as diastolic?

A

Mitral stenosis - just before 1st heart sound
Aortic regurgitation - just after 2nd heart sound
NOT IN TIME WITH CAROTID PULSE

35
Q

List the classical symptoms suggesting valve disease

A 
Chest pain
SOB
Ankle swelling
Collapse/dizzy spells
Exertional symptoms
36
Q

What classification system is used to assess valve disease?

A

New York Heart functional classification

37
Q

What are the three types of valvular disease?

A

Stenosis (don’t open properly)
Regurgitation (do’t close properly)
Mixed

38
Q

What are some symptoms of mitral regurgitation?

A

SOB
Peripheral oedema
Fatigue

39
Q

Name some treatment for aortic regurgitation

A

ACEi

LV dilatation valve replacement

Y1 CARDIOLOGY (16 decks)

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