VALVE DISEASE Flashcards

1
Q

clinical history

A
crushing chest pain 
breathlessness
ankle/sacral swelling 
orthopnea 
PND
syncope/pre-syncope
exertional symptoms
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2
Q

signs of R sided heart failure

A

raised JVP
pitting oedema
hepatic congestion

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3
Q

tapping apex beat (palpable S1)

A

mitral stenosis

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4
Q

when is the apex beat displaced?

A

LV dilatation- volume overload

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5
Q

murmur

A

audible turbulence of blood flow

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6
Q

S1

A

start of systole

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7
Q

S2

A

start of diastole

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8
Q

which murmurs are always pathological?

A

diastolic

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9
Q

2nd heart sound splitting

A

aortic stenosis

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10
Q

3rd sound

A

aortic regurgitation

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11
Q

4th sound

A

mitral stenosis

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12
Q

systolic clicks

A

continuous murmur

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13
Q

innocent murmur

A

tricuspid regurgitation

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14
Q

pericardial rub

A

mitral regurgitation

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15
Q

valve stenosis

A

valves which do not open properly

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16
Q

valve regurgitation

A

valves which do not close properly

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17
Q

mixed valve disease

A

valves which neither open nor close properly

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18
Q

which murmur can be caused by old age (degenerative)?

A

aortic stenosis

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19
Q

congenital murmur

A
aortic stenosis (bicuspid valve)
rarely mitral stenosis
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20
Q

rheumatic fever

A

mainly mitral stenosis

but all others too

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21
Q

breathlessness

A

all murmurs

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22
Q

chest pain

A

aortic stenosis

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23
Q

pre-syncope/syncope

A

aortic stenosis

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24
Q

signs of aortic stenosis

A

low volume pulse
forceful displaced apex
ejection systolic murmur that can radiate to the carotids

25
Q

valve replacement

A

both types of stenosis

aortic regurgitation

26
Q

trans-catheter aortic valve replacement (TAVI)

A

aortic stenosis

27
Q

balloon aortic valvotomy (BAV)

A

aortic stenosis

28
Q

treatment for aortic stenosis

A

valve replacement
TAVI
BAV

29
Q

causes of aortic stenosis

A

old age (degenerative)
congenital (bicuspid valve)
rheumatic fever

30
Q

symptoms of aortic stenosis

A

breathlessness
chest pain
pre-syncope/syncope

31
Q

myxomatous cause (floppy valve)

A

mitral regurgitation

32
Q

endocarditis

A

both types of regurgitation

33
Q

chordae rupture (degenrative)

A

mitral regurgitation

34
Q

papillary muscle rupture due to ischaemia

A

mitral regurgitation

35
Q

causes of mitral regurgitation

A

rheumatic
myxomatous
chordae rupture (degenerative)
papillary muscle rupture due to ischaemia

36
Q

peripheral oedema

A

mitral regurgitation

37
Q

fatigue

A

mitral valves

38
Q

signs of mitral regurgitation

A
displaced apex (cardiomegaly) 
pan systolic murmur
39
Q

treatment of mitral regurgitation

A

diuretics
ACEi
repair- prolapse
replacement- degenerative

40
Q

causes of mitral stenosis

A

mainly rheumatic

congenital rare

41
Q

palpitations (AF)

A

mitral stenosis

42
Q

symptoms of mitral stenosis

A

breathlessness
fatigue
palpitations (AF)

43
Q

malar flush

A

mitral stenosis

44
Q

tapping apex beat

A

mitral stenosis

45
Q

mid diastolic rumbling- diastolic murmur localised to apex

A

mitral stenosis

46
Q

straight left heart border on CXR

A

mitral stenosis

47
Q

signs of mitral stenosis

A

malar flush
tapping apex beat
mid diastolic rumbling- diastolic murmur localised to apex
straight left heart border on CXR

48
Q

treatment of mitral stenosis

A

diuretics and treat AF
valve replacement
balloon valvuloplasty

49
Q

connective tissue disease

A

aortic regurgitation

50
Q

marfans

A

aortic regurgitation

51
Q

aortic dissection

A

aortic regurgitation

52
Q

causes of aortic regurgitation

A
endocarditis 
connective tissue disease
rheumatic 
marfans 
aortic dissection
53
Q

symptoms of aortic regurgitation

A

breathlessness

54
Q

collapsing pulse

A

aortic regurgitation

55
Q

wide pulse pressure

A

aortic regurgitation

56
Q

early diastolic murmur left sternal edge

A

aortic regurgitation

57
Q

cardiomegaly on CXR

A

aortic regurgitation

58
Q

signs of aortic regurgitation

A
collapsing pulse
wide pulse pressure 
displaced apex 
early diastolic murmur left sternal edge 
cardiomegaly on CXR
59
Q

treatment of aortic regurgitation

A

ACEi

valve replacement