Valvular Disease

Question 1

What is the cause of which de novo heart failure (HF) in a patient with signs of acute pulmonary edema (dyspnea, tachypnea, bilateral crackles), hemodynamic compromise (decreased blood pressure, tachycardia, diaphoresis), and a new systolic murmur heard best at the cardiac apex within 2–7 days of MI?

Answer 1

acute mitral regurgitation (MR).

Question 2

What is the likely diagnosis in an elderly patient with syncope, dyspnea, and a slow-rising/delayed pulse?

Answer 2

Aortic stenosis

Question 3

A murmur due to mitral regurgitation may radiate to

Answer 3

the axilla

Question 4

What valvular dysfunction is most likely to be detected in a patient with a history of a “heart murmur” that develops infective endocarditis?

Answer 4

Mitral regurgitation

Question 5

What are the most common heart valves affected by rheumatic heart disease?

Answer 5

1. Mitral valve
2. Aortic valve

Question 6

What is the effect of aortic regurgitation on systolic pressure?
What is the effect of aortic regurgitation on diastolic pressure?

Answer 6

Increased pressure
Decreased pressure

Question 7

Four associated cardiac problems with Marfan syndrome:

Answer 7

• Mitral Valve Prolapse
• Thoracic aortic aneurysm
• Aortic dissection
• Aortic regurgitation

Question 8

Most common cause of aortic regurgitation in:
Developing countries = Developed countries =

Answer 8

• Rheumatic heart disease
• Congenital bicuspid aortic valve (BAV)

Question 9

What murmur is best heard with the patient sitting up, leaning forward, and holding their breath in full expiration?

Answer 9

Aortic regurgitation

Question 10

Diagnosis of a patient with a blowing diastolic heart murmur with bounding pulses, widened pulse pressure, head bobbing

Answer 10

Aortic regurgitation

Question 11

One possible complication of mitral stenosis is ____ due to left atrial dilatation and compression of surrounding structures

Answer 11

dysphagia and hoarseness

Question 12

What is the likely diagnosis in a young patient from a developing country that presents with dyspnea, hemoptysis, and occasional palpitations?

Answer 12

Mitral stenosis (from rheumatic heart disease)

Question 13

What is the recommended treatment for a patient that presents with mitral stenosis secondary to suspected rheumatic fever?

Answer 13

Start/continue penicillin prophylaxis

Question 14

Early (acute) lesions of rheumatic heart disease cause:

Answer 14

mitral regurgitation

Question 15

Late (chronic) lesions of rheumatic heart disease cause

Answer 15

mitral stenosis

Question 16

Acquired tricuspid valve regurgitation and signs of right-sided heart failure in a previously healthy patient suggest a diagnosis of ______, for which _____ is the strongest predisposing factor

Answer 16

tricuspid valve endocarditis
intravenous drug use (IVDU)

Question 17

Which heart valve is most frequently involved in infective endocarditis in IV drug users?

Answer 17

Tricuspid valve

Question 18

Which valve is most commonly affected with S. aureus endocarditis?

Answer 18

Tricuspid valve

Question 19

Holosystolic murmur that increases on inspiration =

Answer 19

Tricuspid regurgitation

Question 20

Which common heart murmur presents as a late systolic murmur w/ a midsystolic click?

Answer 20

Mitral valve prolapse (MVP)

Question 21

Connective tissue diseases are associated with which cardiac valve abnormality?

Answer 21

Mitral valve prolapse

Question 22

In developed countries, ____ degeneration is the most common cause of mitral valve degeneration and subsequent mitral valve prolapse/mitral regurgitation

Answer 22

myxomatous

Question 23

One possible complication of mitral stenosis is ____ with associated risk for mural thrombi

Answer 23

atrial fibrillation

Question 24

The murmur in mitral valve prolapse is also associated with a

Answer 24

midsystolic click