VALVES/MURMURS Flashcards
what valvular disease causes large V waves in JVP
tricuspid regurgitation
systolic thrill in aortic area
aortic stenosis
pounding of heart/palpitations angina dyspnoea dizziness what valvular disease
aortic regurgitation
what are the investigations for aortic stenosis
ECG
Echo
machine like murmur
heard below left clavicle
Patent ductus arteriosus
what is the treatment for mitral regurgitation
diuretics, ACEI, Digoxin, warfarin
surgery for severe - valve repair/replacement
percutaneous mitral valve repair
when do people with valvular disease typically get symptoms
exertion
what does a CXR of mitral stenosis look like
LA enlargement - straight left heart border
mitral valve calcification
what would be given if there was AF with mitral stenosis
BB, digoxin, warfarin
what are some s/s mitral regurgitation
palpitations dyspnoea orthopnoea fatigue sweating ankle swelling
murmur best heard at apex with patient lying on LS on expiration
mitral stenosis
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
aortic regurgitation
what are the different grades of valvular disease
1 - quiet
2/3 - loud without thrill
4/5 - loud with thrill
6 - heard without stethoscope
presence of S4
aortic stenosis
what are the 3 main causes of aortic stenosis
congenital abnormalities e.g. bicuspid valve
rheumatic fever
calcification
what does mitral stenosis look like on an ECG
wide p waves, often bifid
tapping apex beat
mitral stenosis
palpitations dyspnoea orthopnoea fatigue sweating ankle swelling what valvular disease
mitral regurgitation
is pulmonary regurgitation systolic or diastolic
diastolic
what is the murmur the patient leans to the left for
mitral stenosis
head bobbing (de mussets sign)
aortic regurgitation
Loud S1, opening snap
mitral stenosis
soft S1, split S2 (3rd HS)
mitral regurgitation
what are some complications of mitral stenosis
RHF
cardiac cachexia
what is the treatment of mitral stenosis
anticoagulation (risk of embolic stroke)
balloon valvotomy - if pliable valve
valve replacement
diuretics for oedema
how do you describe a murmur
systolic/diastolic type loudest radiate grade influenced by respiration
what is the murmur the patient leans forward for
aortic regurgitation
is tricuspid stenosis more common in men or women
women
what are the 2 most common causes of mitral stenosis
rheumatic fever
congenital
carotid pulsation (corrigans sign)
aortic regurgitation
where does pulmonary stenosis radiate
shoulder
what would a CXR of mitral regurgitation show
cardiomegaly
harsh pan systolic murmur best heard at left sternal edge
ventricular septal defect
s/s aortic regurgitation
pounding of heart/palpitations
angina
dyspnoea
dizziness
do systolic or diastolic murmurs coincide with carotid pulse
systolic
heaving apex beat, undisplaced
aortic stenosis
LA enlargement - straight left heart border
mitral valve calcification
CXR showing what?
mitral stenosis
malar flush
mitral stenosis
what is the treatment of aortic stenosis
surgery
valve replacement/transcatheter aortic valve implantation
early diastolic murmur
aortic regurgitation
slow rising pulse
aortic stenosis
soft/absent S2
aortic stenosis
what murmurs are louder on inspiration
right sided
what are 2 complications of aortic stenosis
cardiac arrest
HF
what murmurs are systolic
MRS ASS
Mitral regurgitation
aortic stenosis
bounding / collapsing pulse
aortic regurgitation
how can an MI cause mitral regurgitation
rupture/dysfunction of chordae tendinae / papillary muscles
radiates to carotids and precordium
aortic stenosis
jerky pulse
mitral regurgitation
what are the most common valve diseases secondary to HF and why
tricuspid/mitral regurgitation
enlarged ventricles cause incomplete seal at valves
rumbling mid diastolic murmur
mitral stenosis
does tricuspid regurgitation radiate
no
what is the treatment of aortic regurgitation
treat underlying disease e.g. endocarditis
valve replacement
ACEIs, ARBs, Diuretics
is pulmonary stenosis systolic or diastolic
systolic
low volume pulse
aortic stenosis
mitral stenosis
what qualifies as an innocent murmur
systolic
pulmonary area
no other cardiac problems
what would mixed aortic valve disease show
pluses biferens
apex beat laterally displaced and downwards and is forceful in quality
aortic regurgitation
capillary pulsation in nail bed (quinckies sign)
aortic regurgitation
s/s mitral stenosis
breathless
tiredness
palpitations
MALAR FLUSH
Pan-systolic murmur
mitral regurgitation
crescendo decresendo murmur
aortic stenosis
systolic thrill
mitral regurgitation
aortic stenosis
Pan-systolic murmur
high pitched and blowing murmur that radiates over precordium to left axilla
loudest at apex beat
mitral regurgitation
what are 5 causes of mitral regurgitation
rheumatic fever MV calcification DCM/HCM endocarditis MI
high volume pulse, displaced apex
aortic regurgitation
mitral regurgitation
wide pulse pressure
aortic regurgitation
what are 4 causes of aortic regurgitation
rheumatic fever
IEC
hypertension
marfans/AAD
ejection systolic murmur
aortic stenosis
s/s aortic stenosis
syncope/presyncope
angina
dyspnoea
narrow pulse pressure
aortic stenosis
pulsatile hepatomegaly
tricuspid regurgitation
hepatomegaly ascites abdominal pain dependent oedema what is the valvular disease
tricuspid stenosis
A jerky pulse, double apex beat and an ejection systolic murmur is associated with what
HCM
