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CV Test 5 > Valve Disease > Flashcards

Valve Disease Flashcards

1
Q

What causes S1?

A

Closure of AV valves

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2
Q

What causes S2?

A

Closure of SL valves

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3
Q

In relation to S1 and S2 when does systole occur?

A

Between S1 and S2

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4
Q

In relation to S1 and S2 when does diastole occur?

A

Between S2 and S1

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5
Q

What is S3?

A

Vibration of ventricular wall as filling slows

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6
Q

When does S3 occur?

A

Middle third of diastole

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7
Q

When is S3 normal?

A

Children
Young adults
Pregnancy

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8
Q

If pathological, what is S3 called?

A

Ventricular gallop

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9
Q

If pathological what is S3 associated with?

A

CHF

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10
Q

Where would you see S3 on a phonocardiogram?

A

Closer to and after S2

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11
Q

When does S4 occur?

A

After atrial contraction

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12
Q

In who can S4 be normal?

A

Elderly

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13
Q

If pathological S4 is called?

A

Atrial gallop

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14
Q

In what rhythm is S4 impossible, and why?

A

A fib, because atria arn’t contracting

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15
Q

If pathological S4 can be seen with what conditions?

A

HTN
Atrial stenosis
Angina
MI

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16
Q

Where would you see S4 on a phonocardiogram?

A

After S2 but closer to S1

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17
Q

Where is auscultation of aortic valve?

A

Right sternal border

2nd intercostal space

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18
Q

Where is auscultation of pulmonic valve?

A

Left sternal border

2nd intercostal space

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19
Q

Where is auscultation of tricuspid valve?

A

Left sternal border

5th intercostal space

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20
Q

Where is auscultation of mitral valve?

A

Mid-clavicular line

5th intercostal space

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21
Q

What is valve stenosis?

A

Valve leaflets adhere and are difficult to open

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22
Q

What is valve regurgitation/insufficiency?

A

Leaflets don’t seal and are difficult to close

23
Q

What causes the sound of a heart murmur?

A

Valve lesions cause turbulent flow which is heard as a murmur

24
Q

What valve diseases cause a systolic murmur?

A

Aortic stenosis

Mitral insufficiency

25
Q

What valve disease cause a diastolic murmur?

A

Aortic insufficiency

Mitral stenosis

26
Q

What murmur is the loudest of all the murmurs?

A

Aortic stenosis

27
Q

How does the normal valve function?

A

Responds to pressure gradients
Opens easily
Leaflet edges seal completely

28
Q

Describe a stenotic valve, it’s opening, and what kind of pressure is required

A

Stiff and calcified
Difficult to open
Requires greater pressure

29
Q

Describe the leaflets of a regurgent valve, and it’s seal

A

Leaflet edges are uneven
Fails to seal so it leaks
Difficult to close

30
Q

Which valves are the atrioventricular valves?

A

Right: tricuspid
Left: mitral

31
Q

Which valves are the semilunar valves?

A

Right: pulmonic
Left: aortic

32
Q

Systolic murmur would be heard when (in relation to S1 and S2)?

A

Between S1 and S2

33
Q

Diastolic murmurs would be heard when (in relation to S1 and S2)?

A

Between S2 and S1

-think “luv dub whoosh”

34
Q

What is the primary hemodynamic effect of valve disease?

A

Decreased forward flow

35
Q

What are the secondary hemodynamic effects of valve disease?

A

Compensation maintains forward flow, but eventually decompensation occurs

36
Q

Some congenital syndromes involve what other valves?

A

Tricuspid or pulmonic

37
Q

In general adults get valve disease because of?

A

Congenital anomaly

38
Q

What other way does valve disease occur?

A

It’s acquired

39
Q

What causes chronic acquired valve disease?

A

Congenital anatomical anomaly
Aging
Associated disease: Marfan’s, lupus, cardiomyopathy, etc
History of Rheumatic fever

40
Q

What causes acute acquired valve disease?

A

Acute events:
Ischemia
Endocarditis
Trauma

41
Q

What is the problem with aortic valve disease?

A

Decreased forward SV

42
Q

What compensatory mechanisms occur with aortic valve disease?

A

LV hypertrophy

Increased blood volume

43
Q

Why does blood volume increase as a compensatory mechanism of aortic valve disease?

A

Decreased forward flows causes renal retention of fluid

RBCs increase in response to tissue hypoxia

44
Q

How does increased blood volume help compensate with aortic valve disease?

A

Helps maintain venous return

Increases LVEDP and LVEDV

45
Q

How does LV hypertrophy help with compensation of AV valve disease?

A

Hypertrophied muscle increases force of contraction

46
Q

How/why does AV valve disease lead to ischemia without CAD? (4)

A

Increased ventricular SBP inhibits coronary flow
Increased muscle mass means increased O2 need
Increased LVEDP means decreased CPP
DBP is decreased in aortic regurgitation

47
Q

Anything that increases LVEDP decreases ______?

A

CPP

48
Q

CPP =

A

DBP-LVEDP

49
Q

What is the overall problem with mitral valve disease?

A

Decreased forward SV

50
Q

What are the compensatory mechanisms with MV disease?

A

Increased blood volume

51
Q

How does increased blood volume help compensate for MV disease?

A

Decreased forward SV causes renal retention which helps maintain venous return

52
Q

What are the consequences of MV disease? (4)

A

Enlarged LA
Pulmonary edema
Atrial dysrhythmia
Loss of atrial kick

53
Q

What is the overall goal of valve disease?

A

Promote forward flow

54
Q

Stenotic valve diseases are described by?

A

Pressure gradient across the valve

CV Test 5 (8 decks)

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