Valvular disease Flashcards
This type of valvular disease causes pressure to build up upstream
stenosis
This type of valvular disease causes volume overload and dilation
regurgitation
Without compensation, ventricles will fail, leading to
Cardiogenic shock
What imaging test should be ordered if a pt has SOB, dyspnea, palpitations, syncope, edema?
Echo
Valvular disease workup
EKG, CXR, ECHO, Cultures, Cardiac Cath (rule out CAD or valvular disease)
what valve replacement has a short life span but does not require anticoag therapy
Bioprosthetic
what valve replacement has a long lifespan but requires anticoag (INR>2.5-3.5)
Mechanical
What are the ACC AHA stages for valvular disease
A. risk of valve disease B. Asymp + mild/mod valvular disease C: Asymp with severe valvular disease c1: C without LV dysfuntion c2: C with LH dysfunction d: SXS due to valvular disease
Causes of MS
Rheumatic fever, congenital (rare)
What is the risk from MS that leads to A-Fib
Thromboembolism, give Warfarin
What are the SXS progression of MS
1st Dyspnea, then PND and Orthopnea and Hoarsness, and hemoptosis
PE of this valve disease are Cyanosis, apical distolic thrill (purring cat), JVP, Murmur = snapping open diastolic murmur heard best in the left lateral decub position
MS
What medications do you give to treat MS?
Beta blockers and warfarin. Reduce salt intake.
How do you surgically correct MS
Percutaneous balloon valvuloplasty.
Replace the stenosis over repair.
What valvular disease is associate with Youth, women, thin, pectus excavatum, marfans, ehlers-danlos?
MVP
What is the murmur associated with MVP and what meds do you give
systolic click, beta blockers
What are acute and chronic causes of MR
Acute = chordea rupture Chronic = annular size increase and LV dilation, MVP
what valve disease increases preload and decrease afterload in LV
MR
What’s the MR murmur?
Holosystolic blowing toward axilla with s3 (rapid LV filling)
What could an EKG, CXR and ECHO show MR
EKG = normal CXR = cardiomegaly ECHO = 1+ to 4+ regurg and overestimated EF
What meds and surgical treatment can you do for MR
diuretics, but no med will prevent MR. Repair MR with TMVR
what type of shock can be caused by acute MR, and what meds help Acute MR
cardiogenic.
IV nitro
Who get AS and what are 2 risk factors
> 65
Rheumatic fever, or bicuspid Aortic valves
What valvular disease is associated with Fixed Cardiac output and what does fixed cardiac output mean.
AS.
Patient can not increase CO, so stress tests are contraindicated.
What is the classic sxs of severe AS, and what is AS’s murmur
Syncope, Angina, Dyspnea.
Murmur = Crescendo-Decrescendo at RSB
what meds and surgical procedure fixes AS?
No meds.
TAVR, replace stenosis, repair regurg.
Balloon valvuloplasty
what are some causes of acute and chronic AR
Leaflet root disease
Acute = aortic dissection,
Chronic = Bicuspid AV, root dilation, rheumatic fever
what valve disease leads to increased LV pressure in diastole, leading to LVH, and decreases aortic compliance?
AR
What is the murmur, medication, and axix deviation for AR
Austin flint, water hammer = diastolic decresendo at LSB.
medication (CAB) = CCB, ACE, BetaB
L-axis deviation
Which valve disease is a hemodynamic emergency leading to cardio decompensation, caused by aortic dissection
Acute AR
which valve disease’s CRX shows an widened mediastinum in aortic dissection, and what meds can you give to reduce shearing pressure
Acute AR
Beta blocker
What valve disease leads to Elevated JVD, hepatomegaly, LE edema, and has a diastolic murmur heard at the LSB
TS
70% of patients have this murmur
TR
ID the valvular disease. Pansystolic murmur at 3/4 ICS at LSB, and leads to RHF
TR
What valve disease has EKG findings of RBBB, A-Fib, and RAE
TR
What valvular disease is associated with Tetralogy of fallot, is found in cyanotic babies, and has a cresendo-decresendo murmur at the 3/4 ICS
PS
