Valvular disease

Question 1

severe AS Vmax?

Answer 1

> 4 m/s

Question 2

severe AS delta P mean?

Answer 2

> 40 mmhg

Question 3

severe AS AVA?

Answer 3

<1 cmsq

Question 4

if over 35 with concern for AVR, do what first?

Answer 4

LHC to see if CABG with AVR

Question 5

indications for AVR with AS?

Answer 5

symptomatic AS, severe AS, asymptomatic but need CABG

Question 6

who is a good candidate for TAVR?

Answer 6

patient with high surgical risk with severe AS

Question 7

meds post TAVR?

Answer 7

DAPT 6 months, no AC

Question 8

aortic stenosis effect on LV?

Answer 8

inc LV O2 demand

Question 9

murmur of AS?

Answer 9

paradoxical splitting of S2

Question 10

mitral stenosis physical exam?

Answer 10

low pitch rumbling, opening snap

Question 11

aortic regurgitation PE?

Answer 11

decrescendo diastolic murmur at left sternal border worse with handgrip, leaning forward or holding breath

Question 12

who gets surgery with MR?

Answer 12

symptomatic or asymptomatic with EF 30-60%

Question 13

who needs bridging for AC?

Answer 13

mechanical AVR with clot risk, mechanical MVR, older AVR like ball in cage

Question 14

tricuspid regurgitation murmur?

Answer 14

systolic murmur that increases with inspiration

Question 15

what does arrhythmia do to CO in aortic stenosis?

Answer 15

can drop CO because it prevents appropriate diastolic filling

Question 16

MC post TAVR compliaction?

Answer 16

acute aortic insufficiency

Question 17

acute aortic insufficiency presentation?

Answer 17

can lead to acute MR, but will have hypotension, tachycardia leading to thready pulses and cold extremities

Question 18

MC concern post TAVR?

Answer 18

AI

Question 19

atrial septal defect test of choice?

Answer 19

cardiac cath to determine level of PHTN and size of defect as well as coronary disease

Question 20

Marfan syndrome is a mutation in what?

Answer 20

fibrillin leads to weakened media in arteries

risk for mitral prolapse
aortic dissection

beta myosin in dilated CM

Question 21

pseudocoarctation?

Answer 21

thoracic aortic injury with UE HTN and LE hypotension

Question 22

horse voice with concern for thoracic aortic injury

Answer 22

recurrent laryngeal involvemeent

Question 23

Mitral valve area mild?

Answer 23

> 1.5 cm sq

Question 24

severe MS MVA?

Answer 24

< 1cm sq

Question 25

treatment for a oyung patient with MS and heart failure?

Answer 25

balloon commisurotomy

Question 26

what needs to be ruled out before undergoing mitral commisurotomy?

Answer 26

MR or LA clot