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CR 2 > Valvular disease > Flashcards

Valvular disease Flashcards

1
Q

Define mitral valve prolapse

A

2mm or more systolic prolapse of one or both valve leaflets

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2
Q

Prevelance of mitral valve prolapse?

A

2-3% of population

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3
Q

What is meant by myxamatous degeneration>

A

Deterioration of connective tissue esp in mitral valve

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4
Q

What happens to the mitral valve in people with mitral valve prolapse

A

It prolapses back into the left atrium during systole

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5
Q

What are the signs of mitral valve prolapse

A

Ejections click

Late systolic murmur

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6
Q

Name 3 causes of aortic stenosis

A
  • Calcific disease
  • Congenital bicuspid valve
  • Rheumatic disease
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7
Q

Name the symptoms of aortic stenosis (5)

A
  • Dyspnoea
  • Angina
  • Syncope
  • Left ventricular failure
  • Sudden death
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8
Q

Why is there dyspnoea in aortic stenosis

A

Increased diastolic pressure in still non- compliant left ventricle

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9
Q

Why is there angina in aortic stenosis

A

Increased oxygen demand of hypertrophied left ventricle

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10
Q

Why is the syncope in aortic stenosis?

A

Either due to paroxysmal ventricular arrythmias or exertional cerebral hypoperfusion

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11
Q

Why is the left ventricular failure in aortic stenosis

A

Contractile failure as ventricle dilates

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12
Q

Why can sudden death occur in aortic stenosis

A

Ventricular arrythmias

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13
Q

3 signs of aortic stenosis

A
  • Slow rising carotid pulse
  • S4 noise with or without ejection click
  • Ejection systolic murmu
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14
Q

3 indications for surgery to treat aortic stenosis?

A
  • Any symptoms of AS
  • Echo evidence of worsening LV dilation
  • Peak systolic pressure gradient >50mmHg
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15
Q

Define aortic stenosis

A

Narrowing of aortic valve opening

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16
Q

Define aortic regurgitation

A

Blood goes back from aorta to left ventricle

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17
Q

What aortic valve leaflet diseases can lead to aortic regurgitation (4)

A
  • Calcific disease
  • Congenital bicuspid valve
  • Rheumatic disease
  • Infective endocarditis
18
Q

What aortic root dilating diseases can lead to aortic regurgitation

A
  • Ankylosing spondylitis
  • Marfan syndrome
  • Aortic dissection
19
Q

Symptoms of aortic regurgitation

A
  • Often none
  • Dyspnoea
  • Angina
20
Q

Why can dyspnoea be seen in aortic regurgitation

A

Contractile failure as ventricle dilates

21
Q

Why can angina be seen in aortic regurgitation

A
  • Dyspnoea due to contractile failure as ventricle dilates

- Angina due to increased oxygen demand of dilated and hypertrophied LV

22
Q

Signs of aortic regurgitation (3)

A
  • Rapidly rising carotid pulse
  • Early diastolic murmur
  • Ejection murmur
23
Q

Why is there a rapidly rising carotid pulse in aortic regurgitation

A

Vigorous ejection of volume loaded left ventricle

24
Q

Why can an early diastolic murmur be heard in aortic regurgittaion

A

Aortic backflow

25
Q

Why can an ejection murmur be heard in aortic regurgitation?

A

Turbulent ejection from volume loaded left ventricle

26
Q

Main cause of mitral stenosis

A

Rheumatic fever

27
Q

Symptoms of mitral stenosis (4)

A

Dyspnoea
Right ventricular failure
Palpitation
Systemic emboli

28
Q

Why is dyspnoea present in mitral stenosis

A

Left atrial pressure increases

29
Q

Why is right ventricular failure a symptom of mitral stenosis

A

Passive consequence of increased left atrial pressure and reactive pulmonary vasoconstriction

30
Q

Why are palpitation a symptom of mitral stenosis

A

Atrial fibrillation

31
Q

Why is systemic emboli a symptom of mitral stenosis

A

Static blood within dilated fibrillating left atrium predisposes to thrombosis

32
Q

What can be auscultated in mitral stenosis

A

Loud first heart sound
Mid-diastolic rumble
Pre-systolic murmur (sometimes)

33
Q

What is pulse like of somebody with mitral stenosis

A

Atrial fibrillation

34
Q

What symptoms does a volume overload cause in mitral stenosis

A

Raised JVP
Basal creps
Ankle oedema

35
Q

What are the requirements to be able to treat mitral stenosis with a valvuloplasty?

A

Noncalcified valve
No mitral regurgitation
No LA thrombus

36
Q

What mitral valve leaflet diseases can cause mitral regurgitation

A

Mitral valve prolapse
Rheumatic disease
Infective endocarditis

37
Q

What subvalvular diseases can lead to mitral regurgitation

A

Chordal rupture
Papillary muscle dysfunction
Papillary muscle rupture

38
Q

Symptoms of mitral regurgitation

A
  • Dyspnoea
  • Palpitation
  • Sytemic emboli
39
Q

Explain the symptoms of mitral regurgitation

A

Dyspnoea happens due to increased LA pressure
Palpitations happen due to af
Sytemic emboli happens due to static blood within dilated fibrillating LA

40
Q

What is pulse like in something with mitral regurgitation

A

AF PULSE

41
Q

What can be heard when ausculatin somebody with mitral regurgitation

A

Pansystolic murmur

S3

42
Q

What medical (non-surgical) treatments can be used for valve disease

A

Diuretics to treat fluid retention
Vasodilators
BB, digoxin to treat AF
Anticoagulants to prevent embolism

CR 2 (33 decks)

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