Valves Flashcards

1
Q

Symptoms of patients with valve disease

A

Chest pain
Dyspnoea
Syncope

On exertion

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2
Q

What is a cardiac murmur?

A

Audible turbulent blood flow

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3
Q

MITRAL REGURGITATION - systolic or diastolic?

A

Systolic`

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4
Q

AORTIC REGURGITATION - systolic or diastolic?

A

Diastolic

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5
Q

MITRAL STENOSIS - systolic or diastolic?

A

Diastolic

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6
Q

AORTIC STENOSIS - systolic or diastolic?

A

Systolic

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7
Q

Where is the AORTIC region?

A

2nd right intercostal space

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8
Q

Where is the PULMONARY region?

A

2nd left intercostal space

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9
Q

Where is the TRICUSPID region?

A

4th left intercostal space

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10
Q

Where is the MITRAL region?

A

5 left intercostal space, mid-clavicular line

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11
Q

TRICUSPID STENOSIS - systolic or diastolic?

A

Diastolic

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12
Q

PULMONARY REGURGITATION - systolic or diastolic?

A

Diastolic

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13
Q

TRICUSPID REGURGITATION - systolic or diastolic?

A

Systolic

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14
Q

PULMONARY STENOSIS - systolic or diastolic?

A

Systolic

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15
Q

How would you describe murmurs?

A

Timing - Systole or Diastole
Type - Early/Mid/Late systolic or diastolic
Location - APTM?
Radiation - To the neck or axilla?
Grade - Rate out of 6. 1 being very weak. 6 being audible without the stethoscope placed on the chest
Is it influenced by respiration?

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16
Q

Which valves close on LUB?

A

Mitral and tricuspid

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17
Q

Which valves close on DUB?

A

Aortic and pulmonary

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18
Q

What are the 2 types of systolic murmur?

A

Pansystolic or ejection systolic

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19
Q

What are the 2 types of diastolic?

A
Early diastolic (decrescendo)
Mid-diastolic
20
Q

Where does aortic stenosis radiate to?

A

The carotids`

21
Q

Where does mitral regurgitation radiate to?

A

The axilla and inferior edge of the scapula

22
Q

Which murmurs are pansystolic?

A

Mitral regurgitation and tricuspid regurgitation (and ventricular septal defect)

23
Q

Which murmurs are ejection systolic?

A

Aortic and pulmonary stenosis

24
Q

Which is murmur is early diastolic?

A

Aortic regurgitation

25
Q

Which murmur is mid-diastolic?

A

Mitral and tricuspid stenosis

26
Q

A murmur is louder on inspiration, which side of the heart does originate from?

A

Right side

27
Q

What is stenosis of the valves?

A

Valves that don’t open properly

28
Q

What is regurgitation of the valves?

A

Valves that don’t close properly

29
Q

What is mixed valve disease?

A

Valves that don’t open AND close properly

30
Q

What causes aortic stenosis?

A

Congenitally bicuspid valve
Age related/degenerative
Rheumatic

31
Q

What are the symptoms of aortic stenosis?

A

Initially asymptomatic
Breathlessness
Chest pain
Dizziness/syncope

32
Q

What are the signs of aortic stenosis?

A

Low volume pulse - slow rising.
Forceful apex - LV heave (leads to LV hypertrophy because of increase end diastolic pressure)
Ejection systolic murmur radiating to the carotids

33
Q

What is the treatment for aortic stenosis?

A

Surgery - valve replacement
Balloon Aortic valvotomy
Transcatheter aortic valve implantation

34
Q

What are the causes of mitral regurgitation?

A
Rheumatic heart disease
Myxomatous degeneration (Floppy mitral valves)
Endocarditis
Chordal rupture
Ischaemia/infarction
LV Dilatation
35
Q

What are the symptoms of mitral regurgitation?

A

Dyspnoea
Ankle swelling
Fatigue

36
Q

What are the signs of mitral regurgitation?

A

Displaced apex beat

Pansystolic murmur - Radiating to axilla

37
Q

What is the treament for mitral regurgitation

A

Drugs - Diuretics/ACE Inhibitors

Surgery - Valve replacement/repair

38
Q

What are the symptoms of mitral stenosis?

A

Dyspnoea
Tiredness
Palpitations

39
Q

What are the causes of mitral stenosis?

A

Rheumatic heart disease

Congenital (Rare)

40
Q

What are the signs of mitral stenosis?

A
Malar flush
Tapping apex beat
Mid diastolic murmur (localised to apex)
Later stages: Right sided heart failure
Straight left heart border on CXR
41
Q

What is the treatment for mitral stenosis?

A

Drugs - Diuretics, beta blockers, digoxin, warfarin.
Surgery - valve replacement
Mitral balloon valvuloplasty

42
Q

What are the causes of aortic regurgitation?

A

Infective endocarditis
Connective tissue disease - Marfan’s
Rheumatic heart disease
Acute aortic dissection

43
Q

What are the symptoms of aortic regurgitation?

A

Dyspnoea
Chest pain
Dizziness

44
Q

What are the signs of aortic regurgitation?

A

COLLAPSING PULSE
Displaced apex
Early diastolic murmur lower left sternal edge
Cardiomegaly on CXR

45
Q

What is the treatment for aortic regurgitation?

A

Drugs - ACE inhibitors, ARBs, Diuretic.

Surgery - Valve replacement

46
Q

Which are more common? Left or right sided valve problems?

A

Left