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Cardio > Valve Disease (Newman) > Flashcards

Valve Disease (Newman) Flashcards

1
Q

2 causes of endocarditis

A

bugs in blood and diseased valve

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2
Q

What determines the integrity of the valves?

A

leaflets/cusps
support network
cardiac chambers, great vessels

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3
Q

a narrowing of an orifice, lumen

A

stenosis

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4
Q

leakage upstream

A

regurgitation

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5
Q

What the size diff of healthy and stenotic valve?

A

3 cm vs 0.5 cm

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6
Q

in what valve does regurgication happen most common?

A

aorta (in diastole)&raquo_space; mitral/left ventricle (in systole)

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7
Q

What is the cardiac adaptation to a stenotic valve?

Does a stenotic valve cause a pressure or volume overload?

A

inc thickness of wall = concentric hypertrophy

pressure overload due to inc pressure upstream

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8
Q

What is the cardiac adaptation to regurgitation?

Does a regurgitation cause an pressure or volume overload?

A

eccentric hypertrophy (enlarged chamber inc mass but normal thickness)

= heart dialtes without getting thicker!!
(volume overload bc volume increases upstream)

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9
Q

What is the thickness of the inter-ventricular septum?

A

1 cm

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10
Q

loud murmur without hypertrophy (eccentric)

A

acute regurgitation

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11
Q

What causes acute regurg? (3)

A

ischemia, infection, dissection

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12
Q 
heart failure (PND, edema, JVD)
chest pain
syncope
arrhymias
** could be asymptomatic
A

acute regurgitation

chest pain (angina)

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13
Q

Where on the chest would you hear mitral regurg

A

right under left nipple

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14
Q

mitral regurg murmur is heard during _____

A

systolic murmur

lub –fhh–dub

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15
Q

aortic regurg murmur is heard during _____

A

diastolic murmur

lub-dub-fhh

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16
Q

Where on the chest would you hear aortic regurg?

A

under right clavicle

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17
Q

aortic stenosis murmur is heard during _____

A

Systole

lub-ugh-dub (cough sound)

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18
Q

in mitral stenosis the first heart sound is

A

louder

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19
Q

how must a pt be positioned? WHat part of hand do you use to feel for it?

A

left lateral dequibitis

interphalngeal joints

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20
Q

Where will PMI be felt with eccentric hypertrophy?

A

axilla

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21
Q

What should the size of the PMI be normally? pathologic?

A

size of dime–> quarter

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22
Q

concentric hypertrophy is a risk factor for …

A

CAD

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23
Q

the gradient

A

?

left ventricle pressure < aorta

24
Q

to determine the severity of the stenosis you must know…

A

gradient

CO (or Q)

25
Q

inflammation, scarring of leaflets, chordae, and papillary muscles, frequent calcification

A

mitral stenosis

26
Q

Clinical pres:

dyspnea, RHF, thrombi

A

mitral stenosis

27
Q

HTN: left atrium > pulmonary bed > right heart

A

mitral stenosis

28
Q

pulmonary artery catheter measures

A

left ventricular pressure?

29
Q

disease affecting:
supporting valve structures
leaflets
dilation of left atria

A

mitral regurg

30
Q

loud first heart sound

A

mitral stenosis

31
Q

what is the most common cause of mitral regurg?

A

mitral prolapse

32
Q

leaflets replaced by myxomatous tissue

A

mitral valve prolapse –> mitral regurg

33
Q

eccentric hypertrophy is the result of

A

Chronic mitral regurg

34
Q

inc preload with dec afterload

A

mitral regurg

35
Q

What are the 2 most common causes of mitral regurg?

A

infection (endocarditis)

ischemia (MI)

36
Q

loud murmus, pulmonary edema, without enlarged ventricle or atia

A

acute mitral regurg

37
Q

hwo is accute and chronic regurg diff?

A

lack of hypertrophy = acute

38
Q

lub- ugh -dub heard under right clavicle

A

aortic stenosis

39
Q

tardus

A

delayed arterial pressure (stays a little longer on your finger)

40
Q

parvus

A

weakened arterial pulse

41
Q

concentric hypertrophy + tardus + parvus

A

aortic stenosis

42
Q

angina
syncope
HF
sudden death

A

arotyic stenossi

43
Q

lub-dub-shh under right clavicle

A

aortic regurg

44
Q

wide pulse pressure

A

chronic aortic regurg

45
Q

bacteremia + disease valve (or lesion)

A

2 requirements for endocaditis

46
Q

combo of platelets + fibrin + bugs + RBCs and WBCs

A

vegetation

47
Q

valve destruction –>

A

acute regurg

48
Q

complications of infective endocarditis

A

valve destruction –> acute regurg
embolization
immunologic phenomena

49
Q

What are the 3 indications for surgery in IE

A
  1. heart failure unresponsive to medical management
  2. uncontrolled infection
  3. recurrent major emboli
50
Q

Turbulent flow is indicative of…

A

stenosis

51
Q

Inappropriate timing is indicative of…

A

regurgitation

52
Q

Severity of stenosis is determined by:

A

pressure gradient

CO

53
Q

In mitral stenosis, the severity is proportional to

A

HR

54
Q

SIgns of aortic regurg

A

widened pulse pressure

head bobbing

55
Q

Endocarditis requires:

A

bacteremia

diseased valves

Cardio (26 decks)

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