Valvular Disease Flashcards
What causes the first heart sound (S1)?
Closure of the mitral and tricuspid valves
What cases the second heart sound (S2)?
Closure of the aortic and pulmonic valves
What usually causes an S3 sound?
A flaccid and inelastic heart (heart failure)
What usually causes an S4 sound?
Atrial systole
What is a normal aortic valve orifice?
2.5-3.5 cm
What is severe aortic stenosis?
0.8 cm
What are the three causes of aortic stenosis?
Bicuspid valve
Rheumatic Fever
Endocarditis
How does the pressure volume loop change in a patient with aortic stenosis?
What is the classic presentation of AS?
It’s SAD
Syncope
Angina
DOE
Why is a decrease in SVR such a problem with aortic stenosis?
The stroke volume of the heart is determined by the aortic valve. The heart can’t increase it’s SV to compensate for a decrease in SVR. So any decrease in SVR leads to a decrease in CO, and a decrease in coronary perfusion pressure
Aortic stenosis may cause two alterations in an arterial waveform:
Pulsus Parvus (small amplitude)
Pulsus Tardus (slow upstroke)
How does aortic regurgitation impact the pressure volume loop?
What usually causes acute aortic regurgitation?
Usually endocarditis, but may also be Ao Root dissection or trauma
What usually causes chronic aortic regurgitation?
Valvular Calcification
Marfan
Ehlers-Danlos
Ankylosing Spondilitis
How can aortic regurgitation impact the arterial waveform?
Bisferiens pulse
How does mitral stenosis impact the pressure volume loop?
How does mitral regurgitation impact the PV loop?
