Valvular Disease

Question 1

What kind of murmur would you hear with aortic stenosis?

Answer 1

Systolic murmur. Slow rising, prolonged pulse (crescendo-decrescendo) AKA. Pulsus parvus et tardus (weak and delayed)

Question 2

What would you see on a CXR with aortic stenosis?

Answer 2

Pulmonary congestion and boot shaped heart from LVH

Question 3

Treatment for aortic stenosis?

Answer 3

Medical management, valvuloplasty, aortic valve replacement

Question 4

What are some of the physiological changes with aortic regurgitation?

Answer 4

Increased end-diastolic volume and ventricular dilation

Question 5

What drugs cause aortic regurgitation?

Answer 5

Phentermine-fenfluramine

Question 6

What would show up on cardiac catheterization for aortic regurgitation?

Answer 6

Widened pulse pressure

Question 7

What kind of murmur would you hear with aortic insufficiency?

Answer 7

Widened pulse pressure. Water-hammer pulse. Early diastolic decrescendo

Question 8

Treatment for aortic insufficiency?

Answer 8

Nifedipine ( CCB) and/or ACEIs with delay valve replacement

Question 9

Hallmark sign of mitral valve stenosis?

Answer 9

Abnormally elevated AV pressure gradient. High pressure in atrium, low pressure in ventricle

Question 10

Symptoms of mitral valve stenosis?

Answer 10

Fatigue, dyspnea, hemoptysis, atrial arrhythmias, palpitations, thromboembolic event

Question 11

What would you hear with mitral valve stenosis?

Answer 11

Soft low diastolic rumble at apex in left lateral decubitus position, opening snap in early diastole

Question 12

What is the treatment for mitral valve stenosis?

Answer 12

Control A-fib/A-flutter (commonly beta blockers), valve replacement, percutaneous transvenous mitral valvotomy

Question 13

What kind of murmur would you hear with mitral valve regurgitation?

Answer 13

Holosystolic at apex, may radiate to left axilla. May hear an S3

Question 14

What is the treatment for mitral valve regurg?

Answer 14

Control heart failure with meds- want to decrease fluid volume in heart. Mitral valve replacement/repair.

Question 15

What happens the the ventricle during pulmonary stenosis?

Answer 15

Reduced EF and increased pressure in RV

Question 16

What is the etiology of pulmonary stenosis?

Answer 16

Generally congenital. Can be caused by carcinoid heart disease

Question 17

What would you hear with pulmonary stenosis?

Answer 17

Systolic opening ejection click followed by systolic ejection murmur that radiates to base

Question 18

Treatment for symptomatic pulmonary stenosis?

Answer 18

Commissurotomy

Question 19

Treatment for pulmonary regurgitation?

Answer 19

Treat underlying heart disease

Question 20

What causes pulmonary regurgitation?

Answer 20

Congenital heart disease (ASD), pulmonary hypertension, infective endocarditit

Question 21

What are signs of pulmonary regurg?

Answer 21

CXR- prominent right heart border dilation of SVC, JVD and peripheral edema

Question 22

Tricuspic stenosis causes what?

Answer 22

Inadequate filling of RV during diastole

Question 23

Symptoms of Tricuspid stenosis?

Answer 23

Systemic venous congestion, fatigue, atrial arrhythmias, abdominal discomfort, liver dysfunction (hepatomegaly), peripheral edema

Question 24

Etiology of tricuspid stenosis?

Answer 24

Rheumatic disease, carcinoid heart disease, congenital, IV drug users

Question 25

How do you treat tricupid stenosis?

Answer 25

Med management of HR, valvotomy or ballon valvuloplasty

Question 26

What kind of murmur would you hear with tricuspid regurg?

Answer 26

Holostolic murmur on left sternal border

Question 27

Etiology of tricuspid regurg?

Answer 27

Pulmonary hypertension, rheumatic disease, congenital, endocarditis from drug use

Question 28

Symptoms of tricuspid regurg?

Answer 28

Edema, atrial arrhythmia, fever/ fatigue in endocarditis, liver dysfunction, abdominal discomfort