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Cardiology > Valvular Disease > Flashcards

Valvular Disease Flashcards

1
Q

Valves automatically open/close based on what?

A

Pressure

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2
Q

During systole what two valves are open?

A

Aortic and Pulmonic

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3
Q

During diastole what two valves are open?

A

Tricuspid and Mitral

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4
Q

Where is Erb’s Point heard?

A

Third left intercostal space (left sternal border)

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5
Q

If the right and left valves do not close simultaneously may hear what sounds?

A

“split” S1 or S2

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6
Q

What can splitting of S2 be associated with?

A

Atrial septal defect (ASD)

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7
Q

S3 is associated with change in?

A

Ventricular Compliance

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8
Q

What is regurgitation?

A

Valve is not able to shut completely, allows blood to flow retrograde

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9
Q

What infection causes rheumatic heart disease?

A

Group A Streptococcus (S. pyrogenes)

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10
Q

Rheumatic heart disease causes what fibrotic valvular changes?

A

Mitral regurgitation
Mitral stenosis
Aortic regurgitation
Aortic stenosis

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11
Q

What are the presenting symptoms of rheumatic heart disease?

A

Fever, joint pain, subcutaneous nodules, chorea

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12
Q

What valves have chordea tendinae?

A

AV valves

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13
Q

What is the most common initial symptom in aortic stenosis?

A

Dyspnea, due to decreased CO

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14
Q

What are the symptoms of aortic stenosis?

A

Heart failure
Angina
Syncope

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15
Q

If a patient with aortic stenosis has a syncopal episode what is the emergent treatment?

A

Emergent stent

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16
Q

What is the most common cause of outflow obstruction in kiddos and adults?

A

Aortic stenosis

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17
Q

What is the number one risk factor for aortic stenosis?

A

Age, associated with the aging process (if everyone lived long enough they would develop aortic stenosis)

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18
Q

What is a brain naturetic peptide (BNP) used to diagnose?

A

CHF

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19
Q

Does aortic regurge occur during systole or diastole?

A

Diastole

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20
Q

What is orthopnea?

A

Difficulty breathing while laying flat

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21
Q

What are the presenting symptoms of mitral stenosis?

A

Dyspnea
Orthopnea
Hemoptysis

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22
Q

Why do patients with mitral stenosis present with hemoptysis?

A

Blood vessels are against increased pressure, vessels can rupture. Blood will enter the alveoli and fill airways

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23
Q

Is mitral regurgitation heard during systole or diastole?

A

Systole

24
Q

Tricuspid regurgitation in an IVDU what is the likely bacteria causing the endocarditis?

A

S. aureus

25
Q

Pulmonary stenosis is going to cause what sided heart failure?

A

Right, unable to fill RV

26
Q

What type of edema is going to be seen in pulmonary stenosis?

A

Systemic peripheral edema, you won’t see pulmonary edema because the blood isn’t getting to the lungs because the problem is before the lungs

27
Q

What is a empyema?

A

Puss in the lungs

28
Q

Congenital murmurs are most common in what valves?

A

Aortic or Pulmonic (systolic valves)

29
Q

What illnesses can cause acquired murmurs?

A

Rheumatic Fever (most common)
Endocarditis
Syphilis

30
Q

What is the biggest risk factor for developing valvular disease?

A

Increasing age

31
Q

What are the complications associated with vavlular heart disease?

A

Heart failure
Stroke
Blood Clot
Heart Rhythm abnormalities
Death

32
Q

What is occurring at Systole S1?

A

Ventricular contraction
Aortic and pulmonic valves open, mitral and tricuspid valves close

Louder at apex

33
Q

What is occurring at Diastole S2?

A

Ventricular relaxation
Aortic and pulmonic valves close, and mitral and tricuspid valves open

Louder at the base

34
Q

What is valve stenosis?

A

Leaflets become thick or stiff, may fuse together; results in a narrowed valve opening and reduced blood flow through the valve

35
Q

What is valvular atresia?

A

Valve isn’t formed; a solid sheet of tissue blocks the blood flow between the heart chambers- congenital

36
Q

Murmurs that usually get louder on inspiration are on what side of the heart?

A

Right side

37
Q

Murmurs that usually get louder on expiration are typically on what side of the heart?

A

Left side

38
Q

At what grade murmur can you start to feel a palpable thrill?

A

Grade IV, everything before that doesn’t have a thrill

39
Q

If you feel a thrill it is not an innocent murmur, what grade must it be?

A

> III

40
Q

What are some common causes for innocent murmurs?

A

Temporary increase in blood flow- hyperkinetic states

Exercise
Pregnancy
Fever
Hyperthyroidisn
Anemia
Rapid growth spurts in children

41
Q

A diastolic murmur is always…

A

pathological

42
Q

What valve disorder is most likely with a late systolic murmur?

A

Mitral valve prolapse (not good)

43
Q

What valve disorders are most likely with an early diastolic murmur?

A

Aortic or Pulmonic regurgitation

44
Q

What pattern will be heard on auscultation of a patient with aortic stenosis?

A

Classically a systolic murmur in a Crescendo-decrescendo pattern - high pitched murmur due to high speed blood flow (Burr-dub)

45
Q

Nitrates should be used with caution in aortic stenosis due to what dangerous risk?

A

Severe hypotension

46
Q

When is valve replacement indicated in aortic stenosis?

A

Once symptoms begin or left ventricle dysfunction occurs

47
Q

When grading severity in aortic stenosis a late systolic murmur is indicative of what severity?

A

Severe

48
Q

The most common cause of chronic aortic regurgitation is

A

VSD with aortic valve prolapse

49
Q

What are the symptoms in severe aortic regurgitation?

A

Palpitations
Chest pain
Fatigue
Shortness of breath

50
Q

What two findings are associated with severe aortic regurgitation?

A

“Corrigan’s Pulse”
Austin-Flint murmur

51
Q

What is the treatment for symptomatic acute aortic regurgitation?

A

Prompt aortic valve replacement or repair

52
Q

What is the treatment for chronic aortic regurgitation?

A

Requires aortic valve replacement/repair when symptoms or left ventricular dysfunction develops

53
Q

Does mitral valve prolapse require treatment?

A

Not usually, when it does most commonly treated with a beta-blocker to reduce risk of tachycardia (Atenolol or Proponalol)

54
Q

What is the treatment for mitral stenosis?

A

Patients usually respond to diuretics. Some require rate control with either beta-blockers or calcium channel blockers.

55
Q

What is the treatment for pulmonary valve stenosis?

A

Balloon valvuloplasty for symptomatic patients

Cardiology (15 decks)

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