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CABS2: Cardiology > Valvular Disease > Flashcards

Valvular Disease Flashcards

1
Q

What is eccentric

A

stretching out
dilating

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2
Q

what is concentric

A

getting closer
constricting

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3
Q

During systole what 2 valves are open

A

aortic and pulmonic

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4
Q

during diastole what 2 valves are open

A

tricuspid and mitral

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5
Q

during the start of systole, what valves CLOSE

A

mitral and tricuspid (AV valves)

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6
Q

when systole ends, what valves CLOSE

A

aortic and pulmonic (semilunar valves)

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7
Q

where is Erb’s point

A

third left intercostal space - left sternal border
more for pathology

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8
Q

What is the splitting of S1 indicative of

A

pathologic - asynchronous closure of the mitral and tricuspid valves

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9
Q

what is the splitting of S2 indicative of

A

often heard during inspiration
can be normal or associated with atrial septal defect
aorta closes before the pulmonic with this finding

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10
Q

what is S3 associated with

A

early diastole, ventricular gallop
associated with change in ventricular compliance - dilated cardiomyopathy

Ken-tuc-ky

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11
Q

what is S4 associated with

A

late diastole, atrial gallop
just prior to S1

Ten-nes-see

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12
Q

What happens with stenosis

A

valve is not able to open completely
may be due to fibrosis, sclerosis, calcification - atherosclerosis

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13
Q

What happens with regurgitation

A

valve is not able to shut completely and allows blood to flow retrograde

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14
Q

what is rheumatic heart disease

A

autoimmune response to the initial GAS (group A strep) infection
results in inflammatory response within the CNS, Heart, skin and joints

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15
Q

what is a complication of Group A strep infection

A

Rheumatic fever/rheumatic heart disease

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16
Q

what does rheumatic fever cause within the heart

A

fibrotic valvular changes
-mitral regurgitation
-mitral stenosis
- aortic regurgitation
-aortic stenosis

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17
Q

when does rheumatic fever occur

A

weeks after initial illness (initial complaint will be sore throat - strep)

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18
Q

who is most likely to get rheumatic fever

A

most common in developing countries
- children 5-15
- associated with environmental factors
- to lesser degree, associated with lack of abx

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19
Q

what does chronic rheumatic heart disease lead to

A

valvular diseases

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20
Q

what surrounds the aortic valve

A

annulus that is made up of fibrous ring

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21
Q

what are symptoms of severe aortic stnosis

A

HF
Angina
Syncope

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22
Q

what is the most common initial symptom of aortic stenosis

A

dyspnea

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23
Q

what occurs with jet velocity with aortic stenosis

A

increases from 2m/s to 4m/s

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24
Q

what is aortic stenosis

A

thickening of the aortic valve, with calcification, which leads to increased velocity
decreased opening during systole - causes systolic murmur

25
what are the causes of valvular stenosis
congenital causes - bicuspid, unicuspid, fusion of leaflets at birth calcification of typical tri-leaflet valve Rheumatic heart disease
26
What is BNP used for
Brain naturetic peptide helps determine if patient has CHF released from the ventricles during times of excess stretch
27
when does aortic regurgitation occur
during diastole, the blood that should be within the aorta or systemic circulation is able to reenter the LV results in diastolic murmur
28
what causes aortic regurgitation
bicuspid valve rheumatic heart disease endocarditis traumatic post surgical aortic disease (HTN, aneurysm, dissection, CT d/o)
29
what does aortic root cause
adherence to valvular cusps to seperate - aneurysms, dissection
30
what are mitral stenosis
fibrotic and/or calcified valve reduces the opening/circumference of the valve diastolic heart disease decreased blood flow from the LA to the LV
31
what causes mitral stenosis
rheumatic heart disease older pts end renal disease calcification deposits
32
how big is the normal mitral valve opening
4-6 cm
33
when does mitral valve stenosis become symptomatic
< 2cm opening
34
what is the presentation of mitral stenosis
dyspnea orthopnea hemoptysis
35
how does mitral stenosis cause hemoptsis
leads to BV having increased pressure, vessels can rupture, blood will enter alveoli and fill airways
36
what are the primary mitral regurgitation causes
infective endocarditis (s. viridans, bulky vegetation) rheumatic heart disease mitral valve prolapse CT disorder myocardial infarction (papillary rupture)
37
what are secondary mitral regurgitation causes
valve is normal problem is within the ventricle causing change in the shape of the annulus hypertrophic obstructive cardiomyopathy
38
what is mitral valve prolapse thought to be associated with
autonomic dysfunction and neuroendocrine dysfunction increased catecholamine levels
39
Where is the moderator band located
sits near the papillary muscle and carries a large amount of the RBB to the myocardium of the RV and tricuspid valve
40
what is tricuspid stenosis
rare- typically associated with disease that affect the other valves as well valve becomes non-complaint, difficult to open
41
what does a dilated right atrium increase the risk for
arrhythmia
42
what are the causes of tricuspid stenosis
rheumatic heart disease carcinoid syndrome tumors
43
when are the symptoms of tricuspid regurgitation worse
with increased preload like when doing squats or inspiration
44
what can tricuspid regurgitation cause
pulmonary HTN endocarditis (IVDU, S. aureus) papillary muscle rupture (acute infarction)
45
what occurs with pulmonic stenosis
there is a thickening of the pulmonic valve which leads to increased velocity decreased opening during systole and causes systolic murmur can cause RV hypertrophy
46
What causes pulmonary stenosis
congenital Acquired: carcinoid heart disease due to carcinoid tumors, plaque deposits
47
What occurs with pulmonary regurgitation
valves unable to close properly during diastole, blood is able to flow back from pulmonary circulation into the RV - diastolic heart murmur RV dilation
48
What can cause pulmonary regurgitation
endocarditis Carcinoid syndrome post-surgical changes after balloon dilation for TOF
49
What is vegetation
size of the thrombus/bacteria will enlarge
50
what happens to the valves with endocarditis
valvular destruction due to the body fighting the bacteria and the bacteria releasing proteases
51
What is FROM JANE
signs of bacterial endocarditis Fever Roth spots Osler nodes Murmur Janeway lesions Anemia Nail-bed hemorrhages Emboli
52
What is the Duke Criteria
is how you can diagnose endocarditis need 2 major or 1 Major and 2 minor positives or 5 minors
53
What is a septic emboli
vegetations on the right side will shed into the pulmonary circulation vegetation on the left side will shed into the systemic circulation can have Osler nodes and Roth sports associated with immune response
54
What are the causes of endocarditis
IVDU structural heart disease prosthetic valve poor dental hygiene HIV Hemodialysis in kids: associated with congenital valvular disease, nosocomila infection, rheumatic heart disease
55
What are the acute pathogen causes of endocarditis
S.aureus B-hemolytic strep Aerobic gram-negative bacilli
56
what are the subacute pathogen causes of endocarditis
S. viridans S. aureus enterococci Coagulase-negative strep or staph
57
what is the presentation of endocarditis
patients prevent with the illness but also with the valvulopathy and septic emboli Acute: sick (fever, HF, septic emboli, hypotension) Subacute: More non-specific, lesser degree of the above
58
How is endocarditis diagnosed
blood cultures echocardiography clinical findings

CABS2: Cardiology (11 decks)

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