Valvular Disease Flashcards
What kind of murmur would you hear with aortic stenosis?
Systolic murmur. Slow rising, prolonged pulse (crescendo-decrescendo) AKA. Pulsus parvus et tardus (weak and delayed)
What would you see on a CXR with aortic stenosis?
Pulmonary congestion and boot shaped heart from LVH
Treatment for aortic stenosis?
Medical management, valvuloplasty, aortic valve replacement
What are some of the physiological changes with aortic regurgitation?
Increased end-diastolic volume and ventricular dilation
What drugs cause aortic regurgitation?
Phentermine-fenfluramine
What would show up on cardiac catheterization for aortic regurgitation?
Widened pulse pressure
What kind of murmur would you hear with aortic insufficiency?
Widened pulse pressure. Water-hammer pulse. Early diastolic decrescendo
Treatment for aortic insufficiency?
Nifedipine ( CCB) and/or ACEIs with delay valve replacement
Hallmark sign of mitral valve stenosis?
Abnormally elevated AV pressure gradient. High pressure in atrium, low pressure in ventricle
Symptoms of mitral valve stenosis?
Fatigue, dyspnea, hemoptysis, atrial arrhythmias, palpitations, thromboembolic event
What would you hear with mitral valve stenosis?
Soft low diastolic rumble at apex in left lateral decubitus position, opening snap in early diastole
What is the treatment for mitral valve stenosis?
Control A-fib/A-flutter (commonly beta blockers), valve replacement, percutaneous transvenous mitral valvotomy
What kind of murmur would you hear with mitral valve regurgitation?
Holosystolic at apex, may radiate to left axilla. May hear an S3
What is the treatment for mitral valve regurg?
Control heart failure with meds- want to decrease fluid volume in heart. Mitral valve replacement/repair.
What happens the the ventricle during pulmonary stenosis?
Reduced EF and increased pressure in RV
What is the etiology of pulmonary stenosis?
Generally congenital. Can be caused by carcinoid heart disease
What would you hear with pulmonary stenosis?
Systolic opening ejection click followed by systolic ejection murmur that radiates to base
Treatment for symptomatic pulmonary stenosis?
Commissurotomy
Treatment for pulmonary regurgitation?
Treat underlying heart disease
What causes pulmonary regurgitation?
Congenital heart disease (ASD), pulmonary hypertension, infective endocarditit
What are signs of pulmonary regurg?
CXR- prominent right heart border dilation of SVC, JVD and peripheral edema
Tricuspic stenosis causes what?
Inadequate filling of RV during diastole
Symptoms of Tricuspid stenosis?
Systemic venous congestion, fatigue, atrial arrhythmias, abdominal discomfort, liver dysfunction (hepatomegaly), peripheral edema
Etiology of tricuspid stenosis?
Rheumatic disease, carcinoid heart disease, congenital, IV drug users
