valvular disease Flashcards
what are the main symptoms of valvular disease
crushing chest pain, breathlessness (usually related to activity, oedema, orthopnoea, PND), syncope
how many classed of the New York heart association are there
Class I (no limitation) –> class IV (severe limitation of minimal activity/ at rest)
what are signs of right sided heart failure
raised JVP, pitting oedema, hepatic congestion
what can palpating an apex beat reveal
tapping = mitral stenosis, heaving and displaced = LVH
what can palpating a heave left to the sternum can reveal
parasternal heave, RV overload
what does the 1st heart sound signify, which valve close and which murmurs are associated with it?
systole, mitral and tricuspid, mitral regurgitation and aortic stenosis (between S1-S2)
what does the 2nd heart sound signify, which valve close and which murmurs are associated with it?
diastole, aortic and pulmonary, mitral stenosis and aortic regurgitation (after S2)
what 2 terms can be used to describe systolic murmurs
pansystolic (continous), ejecyion (fade away)
what 2 terms can be used to describe diastolic murmurs
early (starts loud and fades away), mid diastolic (gets louder)
how are murmurs graded
1-6
what are the 5 most common murmurs
aortic regurg, aortic stenosis, mitral regurg, mitral stenosis and innocent
describe innocent murmurs (3 points)
soft and symmetrical, systolic, often pulmonary area and only found in 1 place).
which side of the heart has murmurs which are louder on inspiration?
right side
which type of murmur is always pathological
diastolic
what is stenosis
valves don’t open properly
what is regurgitation
valves don’t close properly
what is mixed valve disease
don’t open or close properly
what can cause aortic stenosis?
degenerative (age), congenital or rheumatic
what are the signs of aortic stenosis
(SOB, chest pain syncope), low volume pulse, displaced apex, radiated to carotids
what type of murmur is aortic stenosis
ejection systolic between S1 and S2
how do you treat aortic stenosis
valve replacement, valve implantation (TAVI)
what can cause aortic regurg
leaflets (endocarditis or rheumatic),annulus (marfans or aortic dissection)
what are the signs of aortic regurg
SOB, collapsing pulse, displaced apex
what type of murmur is aortic regurg
early diastolic, heard after S2
how do you treat aortic regurg
meds: ACEi, surgery, valve replacement.
what can cause mitral regurg
leaflet problems, chordae rupture, papillary rupture, annular dilation
what are the signs of mitral regurg
SOB, peripheral oedema, fatigue, displaced apex
what type of murmur is mitral regurg
pansystolic, can radiate to axilla, between S1 and s2
how do you treat mitral regurg
Meds: ACEi and diuretics, surgery repair and replace, percutaneous
what can cause mitral stenosis
rheumatic, rarely congenital
what are the signs of mitral stenosis
SOB, fatigue, palpatations, malar flush, tapping apex
what type of murmur is mitral stenosis
mid diastolic, after S2, AF can be present
how do you treat mitral stenosis
diuretics and treat AF, valve replacement, balloons
