VALVE DISEASE

Question 1

clinical history

Answer 1

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

Question 2

signs of R sided heart failure

Answer 2

raised JVP
pitting oedema
hepatic congestion

Question 3

tapping apex beat (palpable S1)

Answer 3

mitral stenosis

Question 4

when is the apex beat displaced?

Answer 4

LV dilatation- volume overload

Question 5

murmur

Answer 5

audible turbulence of blood flow

Question 6

S1

Answer 6

start of systole

Question 7

S2

Answer 7

start of diastole

Question 8

which murmurs are always pathological?

Answer 8

diastolic

Question 9

2nd heart sound splitting

Answer 9

aortic stenosis

Question 10

3rd sound

Answer 10

aortic regurgitation

Question 11

4th sound

Answer 11

mitral stenosis

Question 12

systolic clicks

Answer 12

continuous murmur

Question 13

innocent murmur

Answer 13

tricuspid regurgitation

Question 14

pericardial rub

Answer 14

mitral regurgitation

Question 15

valve stenosis

Answer 15

valves which do not open properly

Question 16

valve regurgitation

Answer 16

valves which do not close properly

Question 17

mixed valve disease

Answer 17

valves which neither open nor close properly

Question 18

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

Answer 18

aortic stenosis

Question 19

congenital murmur

Answer 19

aortic stenosis (bicuspid valve)
rarely mitral stenosis

Question 20

rheumatic fever

Answer 20

mainly mitral stenosis

but all others too

Question 21

breathlessness

Answer 21

all murmurs

Question 22

chest pain

Answer 22

aortic stenosis

Question 23

pre-syncope/syncope

Answer 23

aortic stenosis

Question 24

signs of aortic stenosis

Answer 24

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

Question 25

valve replacement

Answer 25

both types of stenosis | aortic regurgitation

Question 26

trans-catheter aortic valve replacement (TAVI)

Answer 26

aortic stenosis

Question 27

balloon aortic valvotomy (BAV)

Answer 27

aortic stenosis

Question 28

treatment for aortic stenosis

Answer 28

valve replacement TAVI BAV

Question 29

causes of aortic stenosis

Answer 29

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

Question 30

symptoms of aortic stenosis

Answer 30

breathlessness chest pain pre-syncope/syncope

Question 31

myxomatous cause (floppy valve)

Answer 31

mitral regurgitation

Question 32

endocarditis

Answer 32

both types of regurgitation

Question 33

chordae rupture (degenrative)

Answer 33

mitral regurgitation

Question 34

papillary muscle rupture due to ischaemia

Answer 34

mitral regurgitation

Question 35

causes of mitral regurgitation

Answer 35

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

Question 36

peripheral oedema

Answer 36

mitral regurgitation

Question 37

fatigue

Answer 37

mitral valves

Question 38

signs of mitral regurgitation

Answer 38

``` displaced apex (cardiomegaly) pan systolic murmur ```

Question 39

treatment of mitral regurgitation

Answer 39

diuretics ACEi repair- prolapse replacement- degenerative

Question 40

causes of mitral stenosis

Answer 40

mainly rheumatic | congenital rare

Question 41

palpitations (AF)

Answer 41

mitral stenosis

Question 42

symptoms of mitral stenosis

Answer 42

breathlessness fatigue palpitations (AF)

Question 43

malar flush

Answer 43

mitral stenosis

Question 44

tapping apex beat

Answer 44

mitral stenosis

Question 45

mid diastolic rumbling- diastolic murmur localised to apex

Answer 45

mitral stenosis

Question 46

straight left heart border on CXR

Answer 46

mitral stenosis

Question 47

signs of mitral stenosis

Answer 47

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

Question 48

treatment of mitral stenosis

Answer 48

diuretics and treat AF valve replacement balloon valvuloplasty

Question 49

connective tissue disease

Answer 49

aortic regurgitation

Question 50

marfans

Answer 50

aortic regurgitation

Question 51

aortic dissection

Answer 51

aortic regurgitation

Question 52

causes of aortic regurgitation

Answer 52

``` endocarditis connective tissue disease rheumatic marfans aortic dissection ```

Question 53

symptoms of aortic regurgitation

Answer 53

breathlessness

Question 54

collapsing pulse

Answer 54

aortic regurgitation

Question 55

wide pulse pressure

Answer 55

aortic regurgitation

Question 56

early diastolic murmur left sternal edge

Answer 56

aortic regurgitation

Question 57

cardiomegaly on CXR

Answer 57

aortic regurgitation

Question 58

signs of aortic regurgitation

Answer 58

``` collapsing pulse wide pulse pressure displaced apex early diastolic murmur left sternal edge cardiomegaly on CXR ```

Question 59

treatment of aortic regurgitation

Answer 59

ACEi | valve replacement