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Cardiovascular > Valve Disease > Flashcards

Valve Disease Flashcards

1
Q

what are the common signs?

A

exertional symptoms
chest pain
breathlessness
collapse/ dizzy spells

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2
Q

describe cardiac breathlessness

A

related to activity (usually)
often associated with ankle swelling
orthopnoea
paroxysmal nocturnal dyspnoea

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3
Q

describe the NY Heart Association Functional Classification

A

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

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4
Q

what are the signs of right side heart failure?

A

raised JVP
pitting oedema
hepatic congestion

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5
Q

describe the use of the apex beat

A

normally 5th intercostal space midclavicular line
tapping apex in mitral stenosis
displaced and diffuse in left ventricular dilatation (volume overload)
heaving and may be displaced in left ventricular hypertrophy (pressure overload)

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6
Q

what is a parasternal heave?

A

hand left of sternum
right ventricular overload
cor pulmonale/ pulmonary hypertension

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7
Q

what is a cardiac murmur?

A

audible turbulence of blood flow

can be both innocent and pathological

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8
Q

aortic valve

A

2nd- 3rd right intercostal space

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9
Q

pulmonary valve

A

2-3rd left intercostal space

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10
Q

tricuspid valve

A

left sternal border

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11
Q

mitral valve

A

apex

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12
Q

describing murmurs

A 
systole or diastole?
what type of murmur?
where is it loudest?
where does it radiate to?
what grade or murmur?
influenced by respiration?
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13
Q

types of systolic murmurs

A

pansystolic

ejection systolic

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14
Q

types of diastolic murmurs

A

early diastolic

mid diastolic

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15
Q

radiation of murmurs

A

carotids (aortic stenosis)

axilla (mitral regurgitation)

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16
Q

grading of murmurs

A 
I. Very quiet 
II. Quiet - easy to hear
III. Loud
IV. Loud with a thrill
V. Very loud with a thrill
VI. Loud  - audible without a 		stethoscope
17
Q

right vs left sided murmurs

A

right sided murmurs are louder with inspiration

18
Q

additional heart sounds

A 
common
innocent murmur 
mitral regurgitation
aortic stenosis 
aortic regurgitation
mitral stenosis 
less common
2nd sound splitting 
3rd sound
4th sound 
systolic clicks
continuous murmur
tricuspid regurgitation 
pericardial rub
19
Q

innocent (functional) murmur

A

soft (less than 3/6 severity)
position dependant
often early systolic

20
Q

valve stenosis

A

valves which do not open properly

21
Q

valve regurgitation

A

valves which do not close properly

22
Q

mixed valve disease

A

valves which neither open properly not close properly

23
Q

reasons for aortic stenosis

A

degenerative (age related)
congenital eg bicuspid valve
rheumatic

24
Q

symptoms and signs of aortic stenosis

A 
breathlessness
chest pain 
dizziness/ syncope
low volume pulse
forceful displaced apex
ejection systolic murmur than can radiate to the carotids
25
Q

treatment of aortic stenosis

A

conventional valve replacement
trans catheter aortic valve replacement
balloon aortic valvotomy

26
Q

mechanical heart valves

A

longevity
warfarin
younger patients

27
Q

bio-prosthetic heart valves

A

no warfarin
10 years
older patients

28
Q

aortic valve replacement

A

preferred to TAVI
long term outcomes
no contra-indications
CABG as well

29
Q

trans catheter aortic valve replacement

A

co-morbidity

previous sternotomy

30
Q

causes of mitral regurgitation

A 
leaflets 
- prolapse
- rheumatic
- myxomatous (floppy)
- endocarditis
chordae rupture (degenerative)
- prolapse/ flail leaflet
papillary muscles rupture 
- ischaemic 
annular dilatation
- functional
31
Q

symptoms and signs of mitral regurgitation

A 
breathlessness
peripheral oedema
fatigue
displaced apex
pansystolic murmur
- axilla 
cardiomegaly
32
Q

treatment of mitral regurgitation

A 
medication 
- diuretics and heart failure (ACE inhibitors)
surgical 
- repair- prolapse
- replacement- degenerative 
percutaneous 
- clips in infancy
33
Q

causes of mitral stenosis

A

essentially rheumatic main cause

congenital rare

34
Q

symptoms and signs of mitral stenosis

A 
breathlessness
fatigue 
palpitations 
malar flush 
tapping apex beat 
mid diastolic rumbling 
diastolic murmur localised to apex
straight left heart border
35
Q

treatment of mitral stenosis

A 
medication 
- diuretics and treat AF
surgery 
- valve replacement 
balloon valuloplasty
36
Q

causes of aortic regurgitation

A 
leaflets 
- endocarditis
- connective tissue diseases 
- rheumatic
annulus
- marfan's
- aortic dissection
37
Q

symptoms and signs of aortic regurgitation

A 
breathlessness
collapsing pulse
wide pulse pressure 
displaced apex
early diastolic murmur left sternal edge
cardiomegaly
38
Q

treatment of aortic regurgitation

A 
medication 
- ACE inhibitors
surgery 
- symptoms and LV dilatation 
- valve replacement

Cardiovascular (31 decks)

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