Valve Disease- Newman Flashcards
Which heart sound correlates with the carotid pulse?
S1
What two things are needed for bacterial endocarditis?
- bacterial infection
- damaged valves
The diagnosis of aortic stenosis is best made by what?
H&P
The decision to replace a valve in a patient with aortic stenosis is best made by what?
ECG and cardiac catheterization
Three causes of mitral regurgitation?
- Eccentric hypertrophy of the left ventricle
- Mitral valve prolapse
(most common) - Rheumatic fever
What type of murmur would be heard in aortic regurgitation?
diastolic murmur
What is the adaptation to aortic stenosis?
concentric hypertrophy (pressure overload case)
What is the most common cause of concentric hypertrophy?
HTN
What is the adaptation to aortic regurgitation?
volume increase= volume overload
adaptation-eccentric hypertrophy
What are some things that cause acute regurgitation?
ischemia, infection, dissection
What happens in acute aortic regurgitation?
loud diastolic murmur without hypertrophy because the heart has not had time to adapt yet– leads to high surge in pressure
Where is the mitral valve heard?
PMI (if one has mitral regurgitation you will hear a murmur at that area during systole)
What does an aortic valve stenosis sound like?
systolic murmur that sounds like clearing your throat right under the right clavicle
T or F. The loudness of a murmur correlates well with the severity of the disease
F. You can have mild disease with a loud murmur and vice-versa.
How is stenosis assessed?
pressure gradient (can be assessed by echocardiography) and by cardiac output
How is regurgitation assessed?
assess ejection fraction- normally you will see increased EF via regurgitation via frank-starling mechanisms but eventually the heart will decompensate
“ventricular performance serially”
Causes of mitral stenosis?
rheumatic fever (really, this is the only thing)
What is the result of mitral stenosis?
HTN upstream (left atrium, pulmonary bed, etc.) leading to edema and jugular vein distention
dyspnea, right heart failure, thrombi
The severity of mitral stenosis is related to what?
HR, want to decrease to allow increased filling time during diastole
What are some causes of mitral regurg?
- mitral valve prolapse
- left ventricular (annular) dilation
- rheumatic fever
What does mitral regurg sound like?
clicking sound in systole (if prolapsed)
T or F. Mitral regurgitation is less associated with HTN than stenosis
T.
What are some signs of aortic stenosis?
- concentric hypertrophy
- delayed arterial pulse= tardus
- weakened arterial pulse= parvus
Signs of aortic regurg?
- wide pulse pressure (200/40)
- head bobbing
