valvular disease

Question 1

what are the main symptoms of valvular disease

Answer 1

crushing chest pain, breathlessness (usually related to activity, oedema, orthopnoea, PND), syncope

Question 2

how many classed of the New York heart association are there

Answer 2

Class I (no limitation) –> class IV (severe limitation of minimal activity/ at rest)

Question 3

what are signs of right sided heart failure

Answer 3

raised JVP, pitting oedema, hepatic congestion

Question 4

what can palpating an apex beat reveal

Answer 4

tapping = mitral stenosis, heaving and displaced = LVH

Question 5

what can palpating a heave left to the sternum can reveal

Answer 5

parasternal heave, RV overload

Question 6

what does the 1st heart sound signify, which valve close and which murmurs are associated with it?

Answer 6

systole, mitral and tricuspid, mitral regurgitation and aortic stenosis (between S1-S2)

Question 7

what does the 2nd heart sound signify, which valve close and which murmurs are associated with it?

Answer 7

diastole, aortic and pulmonary, mitral stenosis and aortic regurgitation (after S2)

Question 8

what 2 terms can be used to describe systolic murmurs

Answer 8

pansystolic (continous), ejecyion (fade away)

Question 9

what 2 terms can be used to describe diastolic murmurs

Answer 9

early (starts loud and fades away), mid diastolic (gets louder)

Question 10

how are murmurs graded

Answer 10

1-6

Question 11

what are the 5 most common murmurs

Answer 11

aortic regurg, aortic stenosis, mitral regurg, mitral stenosis and innocent

Question 12

describe innocent murmurs (3 points)

Answer 12

soft and symmetrical, systolic, often pulmonary area and only found in 1 place).

Question 13

which side of the heart has murmurs which are louder on inspiration?

Answer 13

right side

Question 14

which type of murmur is always pathological

Answer 14

diastolic

Question 15

what is stenosis

Answer 15

valves don’t open properly

Question 16

what is regurgitation

Answer 16

valves don’t close properly

Question 17

what is mixed valve disease

Answer 17

don’t open or close properly

Question 18

what can cause aortic stenosis?

Answer 18

degenerative (age), congenital or rheumatic

Question 19

what are the signs of aortic stenosis

Answer 19

(SOB, chest pain syncope), low volume pulse, displaced apex, radiated to carotids

Question 20

what type of murmur is aortic stenosis

Answer 20

ejection systolic between S1 and S2

Question 21

how do you treat aortic stenosis

Answer 21

valve replacement, valve implantation (TAVI)

Question 22

what can cause aortic regurg

Answer 22

leaflets (endocarditis or rheumatic),annulus (marfans or aortic dissection)

Question 23

what are the signs of aortic regurg

Answer 23

SOB, collapsing pulse, displaced apex

Question 24

what type of murmur is aortic regurg

Answer 24

early diastolic, heard after S2

Question 25

how do you treat aortic regurg

Answer 25

meds: ACEi, surgery, valve replacement.

Question 26

what can cause mitral regurg

Answer 26

leaflet problems, chordae rupture, papillary rupture, annular dilation

Question 27

what are the signs of mitral regurg

Answer 27

SOB, peripheral oedema, fatigue, displaced apex

Question 28

what type of murmur is mitral regurg

Answer 28

pansystolic, can radiate to axilla, between S1 and s2

Question 29

how do you treat mitral regurg

Answer 29

Meds: ACEi and diuretics, surgery repair and replace, percutaneous

Question 30

what can cause mitral stenosis

Answer 30

rheumatic, rarely congenital

Question 31

what are the signs of mitral stenosis

Answer 31

SOB, fatigue, palpatations, malar flush, tapping apex

Question 32

what type of murmur is mitral stenosis

Answer 32

mid diastolic, after S2, AF can be present

Question 33

how do you treat mitral stenosis

Answer 33

diuretics and treat AF, valve replacement, balloons