Valvular Disease Flashcards
What will a pt with mitral stenosis have in their hx?
rheumatic fever, signs of left-sided heart failure, ischemic stroke, splinter hemorrhage, osler nodes, janeway lesions
What does mitral stenosis sound like?
mid-diastolic crescendo-decrescendo murmur (“mid diastolic rumble”)
What does aortic insufficiency/regurgitation have on h and p?
wide pulse pressure, hypoperfusion (low bp, poor mentation), thick left ventricle on cxr/echo (maybe aortic dissection hx)
What does aortic insufficiency/regurgitation sound like?
“austin flint”-eccentric, early diastolic decrescendo
What does tricuspid stenosis have in the history?
rheumatic heart disease, IV drug use, endocarditis, or congenital
How do you treat mitral stenosis if it is from rheumatic heart dz?
manage CHF and refer for surgery eventually
How do you treat mitral stenosis from endocarditis?
antibiotics, possibly replace
How do you treat aortic regurgitation?
treat CHF-fluid/salt restriction, possible beta blockers (abx if endocarditis cause), surgery
What does aortic stenosis sound like?
loud, late-peaking, split S2
What does the hx include for aortic stenosis?
old patient, murmur radiates to the carotids, hypoperfusion
What does mitral regurgitation sound like?
soft S1, early and sustained murmur, split S2
What does the hx include for mitral regurg?
current heart attack, signs of left sided failure (wet lungs), murmur radiates to axilla
What type of hx will a VSD murmur present with in adults?
old septal MI, pulmonary HTN, Eisenmengers syndrome (right sided dilation form left sided disease)
What does a PDA murmur sound like?
continuous machine like murmur
When do you replace the valve in aortic stenosis?
angina, syncope or CHF because these things reduce the patient’s life expectancy
