Valvular Flashcards
Risk factors for aortic stenosis
Older age Male Congenital bicuspid valve Rheumatic heart disease
3 main causes of aortic stenosis
Congenital bicuspid aortic valve Rheumatic heart disease Degenerative calcific aortic valve disease
Other causes of aortic stenosis
CT diseases Radiotherapy Hyperlipoproteinaemia
Which valvular heart disease causes: LV hypertrophy –> LA dilation –> reduced CO, reduced systolic pressure gradient –> heart failure (left then right)
Aortic stenosis
Exertional syncope Exertional angina Exertional dyspnea
SAD = Aortic stenosis
3 main Sx of aortic stenosis
exertional: syncope, angina, dyspnea
Narrow pulse pressure
Aortic stenosis
Ejection (mid) systolic murmur
Aortic stenosis murmur
Low-pitched crescendo-decrescendo murmur in the pulmonary area, radiating to the carotids
Aortic stenosis (usually aortic area but can vary) murmur
Ejection systolic murmur that is reduced with Valsalva and increased with standing-to-squatting
Aortic stenosis murumr
S4 heard in which valvular disease?
Aortic stenosis (Vibration of ventricle when atria contract)
On ECG: Left ventricular strain (ST depression and T-inversion in I, aVL and v5,6)
Aortic stenosis
Gold standard Ix for aortic stenosis
Echocardiogram (TTE + Doppler)
Gold standard Rx for aortic stenosis with confirmed survival benefit
Aortic valve replacement
Difference between tissue valves and mechanical valves
Tissue valves: last 15-20 years Mechanical valves: lasts indefinitely but requires long term anticoagulation (warfarin)
Diseases of the aorta that can cause aortic regurgitation
Aortic root dilatation (idiopathic) Aortitis Aortic dissection
Systemic (rheum) diseases that can cause aortic regurgitation
(MARG) Marfan syndrome Ankylosing spondylitis Reactive arthritis Giant cell arteritis
Which acute valvular disease causes: Sudden increase in LV volume –> Inefficient contraction, increased LA pressure –> Pulmonary edema (left heart failure)
Aortic regurgitation
The amount of blood regurgitating compared to the stroke volume is the ..?
Regurgitant fraction
Wide pulse pressure (Decreased diastolic pressure, Increased systolic pressure)
Aortic regurgitation
Dyspnea, palpitations, angina, cyanosis and shock
Aortic regurgitation
Early diastolic murmur
Aortic regurgitation
Decrescendo murmur in early diastole
Aortic regurgitation
When raising arm up, large volume ‘collapsing’ pulse (from high systole then low diastole)
Aortic regurgitation
