Valvular Disease Flashcards
define aortic regurgitation
incompetency of valves/valve roots causing backwards flow of blood into aortic valve
acute causes of aortic regurgitation
infective endocarditis
aortic dissection
traumatic rupture
chronic causes of aortic regurgitation
calcification
rheumatic heart disease
Marfan’s Syndrome
risk factors of aortic regurgitation
previous heart issue (e.g. Marfans, infective endocarditis or congenital bicuspid valve)
acute presentation of aortic regurgitation
sudden cardiac syncope
pulmonary oedema
pallor and sweating
peripheral vasoconstriction
chronic presentation of aortic regurgitation
extertional dysponea
orthopnoea
stable angina
signs of aortic regurgitaiton
early diastolic murmur
pulsation of nail beds (Quincke’s Sign)
wide pulse pressure with sudden collapse (Corrigan’s Pulse)
investigations of aortic regurgitation
echocardiogram
CXR
bloods (FBC, U+E, BNP, ESR, CRP and LFTs)
management of aortic regurgitation
losartan +/- beta blockers
ECHO every 6-12mnths
indications for surgery in aortic regurgitation
significant enlargement of ascending aorta
symptomatic AR
poor left ventricular ejection fraction
infective endocarditis refractory to medical therapy
surgical interventions in aortic regurgitation
aortic valve replacement
TAVI
define aortic stenosis
narrowing of aortic valve cusps occurring progressively
clinical presentation of aortic stenosis
chest pain
cardiac syncope
heart failure
exertional dyspnoea
signs of aortic stenosis
slow rising carotid pulse
narrow pulse pressure
S3 and S4 present
ejection-systolic high pitched murmur
investigations of aortic stenosis
ECG
echocardiogram
CXR
intervention in aortic stenosis requirements
symptomatic AS
asymptomatic with LVEF <50%
surgical management of aortic stenosis
TAVI - those with severe comorbidities, previous heart surgery or >75yrs
SAVR - low risk and <75yrs
medical management of aortic stenosis
ACE inhibitors
beta blockers
diuretics
6-12mnth follow ups
define mitral stenosis
impaired opening of the mitral valve affecting blood flow from left atrium to ventricle
causes of mitral stenosis
rheumatic heart disease
clinical features of mitral stenosis
gradual exertional dyspnoea haemoptysis palpitations chest pain hoarseness of voice
signs of mitral stenosis
malar flush low volume pressure atrial fibrillation ⬆️ JVP inspiratory crepitations
investigations in mitral stenosis
ECG
CXR
echocarodiogram
management of unsymptomatic mitral stenosis
regular echocardiograms
management of symptomatic mitral stenosis
balloon valvuloplasty
percutaneous mitral valvotomy
open valve repair/replacement
