Valve Disease

Question 1

Mitral Stenosis Aetiology

Answer 1

Rheumatic Disease

Question 2

Mitral Stenosis Signs

Answer 2

• Malar Flush
• Tapping Apex
• Mid Diastolic best hear in the Apex
• Breathlessness, fatigue and palpitation

Question 3

Mitral Stenosis Tx

Answer 3

Warfarin
Asymptomatic: Regular Echoes
Symptomatic: Valvotomy or Valve Replacement

Question 4

Aortic Stenosis Aetiology

Answer 4

Calcified Vessels if Old

Bicuspid valve if young

Question 5

Aortic Stenosis Signs

Answer 5

• Low volume pulse
• Heaving apex
• Ejection Systolic to the carotids.
• Breathlessness, Chest pain, Dizziness and syncope

Question 6

Aortic Stenosis Treatment

Answer 6

Asymptomatic: Observe
Symptomatic or Valve Gradient >40: Valve Replacement (Surgical in Low Risk and Transcatheter in high Risk)
Children: Baloon Valvuloplasty

Question 7

Mitral Regurgitation Aetiology

Answer 7

• Chordae Rupture
• Pappillary muscle Rupture
• Endocarditis

Question 8

Mitral Regurgitation Signs

Answer 8

• Displaced Apex
• Pansystolic to the axilla
• Breathlessness, peripheral oedema, fatigue

Question 9

Mitral Regurgitation Treatment

Answer 9

Medical Mx: Nitrates, Diuretics +ve inotropes, baloon pump and ACEI in HF
Severe: Valve Repair or replacement if not appropriate

Question 10

Aortic Regurgitation Aetiology

Answer 10

• Endocarditis/Rheumatic Disease
• SLE
• Marfans or Aortic Dissection

Question 11

Aortic Regurgitation SIgns

Answer 11

• • Collapsing pulse, wide pulse pressure, displaced apex and early diastolic at left sternal edge.
• Breathlessness

Question 12

Aortic Regurgitation Treatment

Answer 12

Manage HF

- Surgery in symptomatic or asymptomatic with severe LHF

Question 13

Tricuspid Regurg Aetiology

Answer 13

Right ventricular infarction
Pulmonary HTN
Rheumatic Disease
Infective endo
Ebsteins Anomaly
Carcinoid Syndrome

Question 14

Tricuspid Regurg Signs

Answer 14

Pansystolic
Prominent V waves in JVP
Pulsatile Hepatomegaly
Left parasternal heave