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Cardiovascular > Valvular Disease > Flashcards

Valvular Disease Flashcards

1
Q

When will the apex beat be tapping?

A

Mitral stenosis

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2
Q

When will the apex beat be displaced and diffuse?

A

LV dilatation

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3
Q

When will the apex beat be heaving and possibly displaced?

A

LV hypertrophy

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4
Q

If there is a parasternal heave to the left of the sternum what does this suggest?

A

Cor pulmonale or pulmonary hypertension

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5
Q

What is the best test for valvular disease?

A

ECHO

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6
Q

What is a murmur?

A

Audible turbulence of blood flow

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7
Q

Where do you listen for the aortic valve?

A

2nd right intercostal space (parasternal)

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8
Q

Where do you listen for the mitral valve?

A

At the apex

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9
Q

What makes the first heart sound?

A

Mitral and tricuspid valves closing (systole)

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10
Q

What makes the second heart sound?

A

Aortic and pulmonary valves closing (diastole)

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11
Q

What are the two types of systolic murmurs?

A

Pansystolic and ejection systolic

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12
Q

What are the two types of diastolic murmur?

A

Early diastolic and mid diastolic

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13
Q

What murmur radiates to the carotids?

A

Aortic stenosis

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14
Q

What murmur radiates to the axilla?

A

Mitral regurgitation

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15
Q

Which grade of murmur indicates a thrill?

A

IV

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16
Q

What does grade VI murmur mean?

A

It is audible without a stethoscope

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17
Q

What type of murmurs are louder with inspiration?

A

Right sided

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18
Q

What murmur can cause 2nd sound splitting?

A

Aortic stenosis

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19
Q

What murmur can cause a third sound?

A

AR

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20
Q

What murmur can cause a 4th heart sound?

A

Mitral stenosis

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21
Q

What murmur can cause systolic clicks?

A

A continuous murmur

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22
Q

What is an innocent murmur?

A

Tricuspid regurgitation

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23
Q

What murmur can a pericardial rub cause?

A

MR

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24
Q

What are innocent murmurs commonly?

A

Early systolic (never diastolic)

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25
Q

What is stenosis?

A

Valve doesn’t open properly

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26
Q

What is regurgitation?

A

Valve doesn’t close properly

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27
Q

What are causes of aortic stenosis in the >65s?

A

Calcified valve

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28
Q

What is usually the cause of aortic stenosis in the <65s?

A

Bicuspid valve

29
Q

Can aortic stenosis be rheumatic?

A

Yes

30
Q

What are symptoms of aortic stenosis?

A

Breathless, chest pain, dizziness/syncope

31
Q

How would you describe an aortic stenosis murmur?

A

Early systolic murmur radiating to the carotids

32
Q

What is the treatment for asymptomatic AS?

A

None- observe

33
Q

What is the treatment for asymptomatic AS with a valvular gradient >40mmHg and LV systolic dysfunction?

A

Surgery

34
Q

How would you treat a symptomatic case of AS?

A

Valve replacement or 2nd line balloon valvuloplasty

35
Q

When are mechanical heart valves used?

A

Younger patients

36
Q

Which type of heart valve replacement requires warfarin?

A

Mechanical

37
Q

When are bio-prosthetic heart valves used?

A

Older patients

38
Q

When is a TAVI used instead of a replacement for aortic valve damage?

A

Patients with co-morbidities or a previous sternotomy

39
Q

What are causes of MR?

A

Leaflets, chordae rupture, papillary muscle rupture, annular dilatation

40
Q

What are leaflet causes of MR?

A

Prolapse, rheumatic, myxomatous, endocarditis

41
Q

What are papillary muscle ruptures related to?

A

Ischaemia

42
Q

What are symptoms of MR?

A

Breathless, peripheral oedema, fatigue

43
Q

How would you describe the murmur of MR?

A

Pansystolic murmur radiating to the axilla

44
Q

How can MR be treated medically?

A

Diuretics and heart failure medication (ACE I’s)

45
Q

When are repairs and replacements used for MR?

A

Repair- prolapse

Replacement- degenerative

46
Q

What is a treatment used for MR in infancy?

A

Percutaneous clips

47
Q

What is the main and minor causes of MS?

A

Rheumatoid and rarely congenital

48
Q

What are symptoms of MS?

A

Breathless, fatigue, palpitations (AF)

49
Q

How would you describe the murmur of MS?

A

Mid-diastolic rumbling murmur localised to the apex

50
Q

How can MS be treated medically?

A

Diuretics and treat AF

51
Q

How can MS be treated surgically?

A

Valve replacement or balloon valvuloplasty

52
Q

What are causes of AR?

A

Leaflet (endocarditis, connective tissue disease, rheumatic) or annulus (Marfan’s or aortic dissection)

53
Q

What is the only symptom of AR?

A

Breathlessness

54
Q

How would you describe the murmur of aortic regurgitation?

A

Early diastolic murmur localised to the left sternal edge

55
Q

How can AR be treated medically?

A

ACE inhibitors

56
Q

When should surgery be given for AR and what should it be?

A

Valve replacement if symptomatic with LV dilatation

57
Q

What can cause a displaced apex?

A

Mitral or aortic regurgition

58
Q

Slow rising pulse?

A

AS

59
Q

Loud S1 and opening snap

A

MS

60
Q

Wide pulse pressure?

A

AR

61
Q

Malar flush?

A

MS

62
Q

Narrow pulse pressure?

A

AS

63
Q

Low volume pulse?

A

MS

64
Q

Collapsing pulse?

A

AR

65
Q

Soft S1?

A

MR

66
Q

Soft S2?

A

AS

67
Q

What can cause a forceful displaced apex beat?

A

AS

68
Q

What can cause a straight left heart border?

A

MS

Cardiovascular (23 decks)

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