VALVES/MURMURS Flashcards

1
Q

what valvular disease causes large V waves in JVP

A

tricuspid regurgitation

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2
Q

systolic thrill in aortic area

A

aortic stenosis

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3
Q
pounding of heart/palpitations
angina
dyspnoea
dizziness
what valvular disease
A

aortic regurgitation

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4
Q

what are the investigations for aortic stenosis

A

ECG

Echo

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5
Q

machine like murmur

heard below left clavicle

A

Patent ductus arteriosus

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6
Q

what is the treatment for mitral regurgitation

A

diuretics, ACEI, Digoxin, warfarin
surgery for severe - valve repair/replacement
percutaneous mitral valve repair

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7
Q

when do people with valvular disease typically get symptoms

A

exertion

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8
Q

what does a CXR of mitral stenosis look like

A

LA enlargement - straight left heart border

mitral valve calcification

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9
Q

what would be given if there was AF with mitral stenosis

A

BB, digoxin, warfarin

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10
Q

what are some s/s mitral regurgitation

A
palpitations
dyspnoea
orthopnoea
fatigue
sweating
ankle swelling
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11
Q

murmur best heard at apex with patient lying on LS on expiration

A

mitral stenosis

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12
Q

early diastolic murmur
high pitched and blowing murmur best heard at left sternal edge 4th ICS
with patient leaning forward and breath held in expiration

A

aortic regurgitation

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13
Q

what are the different grades of valvular disease

A

1 - quiet
2/3 - loud without thrill
4/5 - loud with thrill
6 - heard without stethoscope

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14
Q

presence of S4

A

aortic stenosis

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15
Q

what are the 3 main causes of aortic stenosis

A

congenital abnormalities e.g. bicuspid valve
rheumatic fever
calcification

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16
Q

what does mitral stenosis look like on an ECG

A

wide p waves, often bifid

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17
Q

tapping apex beat

A

mitral stenosis

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18
Q
palpitations
dyspnoea
orthopnoea
fatigue
sweating
ankle swelling
what valvular disease
A

mitral regurgitation

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19
Q

is pulmonary regurgitation systolic or diastolic

A

diastolic

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20
Q

what is the murmur the patient leans to the left for

A

mitral stenosis

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21
Q

head bobbing (de mussets sign)

A

aortic regurgitation

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22
Q

Loud S1, opening snap

A

mitral stenosis

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23
Q

soft S1, split S2 (3rd HS)

A

mitral regurgitation

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24
Q

what are some complications of mitral stenosis

A

RHF

cardiac cachexia

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25
what is the treatment of mitral stenosis
anticoagulation (risk of embolic stroke) balloon valvotomy - if pliable valve valve replacement diuretics for oedema
26
how do you describe a murmur
``` systolic/diastolic type loudest radiate grade influenced by respiration ```
27
what is the murmur the patient leans forward for
aortic regurgitation
28
is tricuspid stenosis more common in men or women
women
29
what are the 2 most common causes of mitral stenosis
rheumatic fever | congenital
30
carotid pulsation (corrigans sign)
aortic regurgitation
31
where does pulmonary stenosis radiate
shoulder
32
what would a CXR of mitral regurgitation show
cardiomegaly
33
harsh pan systolic murmur best heard at left sternal edge
ventricular septal defect
34
s/s aortic regurgitation
pounding of heart/palpitations angina dyspnoea dizziness
35
do systolic or diastolic murmurs coincide with carotid pulse
systolic
36
heaving apex beat, undisplaced
aortic stenosis
37
LA enlargement - straight left heart border mitral valve calcification CXR showing what?
mitral stenosis
38
malar flush
mitral stenosis
39
what is the treatment of aortic stenosis
surgery | valve replacement/transcatheter aortic valve implantation
40
early diastolic murmur
aortic regurgitation
41
slow rising pulse
aortic stenosis
42
soft/absent S2
aortic stenosis
43
what murmurs are louder on inspiration
right sided
44
what are 2 complications of aortic stenosis
cardiac arrest | HF
45
what murmurs are systolic
MRS ASS Mitral regurgitation aortic stenosis
46
bounding / collapsing pulse
aortic regurgitation
47
how can an MI cause mitral regurgitation
rupture/dysfunction of chordae tendinae / papillary muscles
48
radiates to carotids and precordium
aortic stenosis
49
jerky pulse
mitral regurgitation
50
what are the most common valve diseases secondary to HF and why
tricuspid/mitral regurgitation | enlarged ventricles cause incomplete seal at valves
51
rumbling mid diastolic murmur
mitral stenosis
52
does tricuspid regurgitation radiate
no
53
what is the treatment of aortic regurgitation
treat underlying disease e.g. endocarditis valve replacement ACEIs, ARBs, Diuretics
54
is pulmonary stenosis systolic or diastolic
systolic
55
low volume pulse
aortic stenosis | mitral stenosis
56
what qualifies as an innocent murmur
systolic pulmonary area no other cardiac problems
57
what would mixed aortic valve disease show
pluses biferens
58
apex beat laterally displaced and downwards and is forceful in quality
aortic regurgitation
59
capillary pulsation in nail bed (quinckies sign)
aortic regurgitation
60
s/s mitral stenosis
breathless tiredness palpitations MALAR FLUSH
61
Pan-systolic murmur
mitral regurgitation
62
crescendo decresendo murmur
aortic stenosis
63
systolic thrill
mitral regurgitation | aortic stenosis
64
Pan-systolic murmur high pitched and blowing murmur that radiates over precordium to left axilla loudest at apex beat
mitral regurgitation
65
what are 5 causes of mitral regurgitation
``` rheumatic fever MV calcification DCM/HCM endocarditis MI ```
66
high volume pulse, displaced apex
aortic regurgitation | mitral regurgitation
67
wide pulse pressure
aortic regurgitation
68
what are 4 causes of aortic regurgitation
rheumatic fever IEC hypertension marfans/AAD
69
ejection systolic murmur
aortic stenosis
70
s/s aortic stenosis
syncope/presyncope angina dyspnoea
71
narrow pulse pressure
aortic stenosis
72
pulsatile hepatomegaly
tricuspid regurgitation
73
``` hepatomegaly ascites abdominal pain dependent oedema what is the valvular disease ```
tricuspid stenosis
74
A jerky pulse, double apex beat and an ejection systolic murmur is associated with what
HCM