Valvular Disease

Question 1

What Ix is used for all valve disease?

Answer 1

ECHO for LV size and function and doppler derived gradient around valve area

Question 2

What is primary cause of Aortic stenosis?

Answer 2

Calcification of valve

Question 3

What are signs of Aortic stenosis?

Answer 3

Slow rising pulse
Narrow pulse pressure
Crescedo decrescendo murmur
Heaving apex beat

Question 4

How is Aortic stenosis managed?

Answer 4

Dental hygiene

TAVI if symptomatic, reduced EF or PCI/CABG happening anyway

Question 5

What is primary cause of mitral regurg?

Answer 5

Myxomatous degeneration

Ischaemia

Question 6

What are signs of mitral regurg?

Answer 6

AF
VOLUME OVERLOAD
Pan systolic murmur radiating to axilla heard loudest when rolled to side
Pulmonary hypertension if progress
Displaced apex beat

Question 7

How is Mitral regurg managed?

Answer 7

ACEi to vasodilate
BB, CCB or Digoxin for AF
Anticoagulate AF
Diuretics

Question 8

What is aetiology of Aortic regurg?

Answer 8

RF

Bicuspid valve

Question 9

What are signs of aortic regurg?

Answer 9

Wide pulse pressure
Displaced apex beat
Waterhammer pulse (collapsing)
Diastolic blowing murmur
Ejection systolic murmur

Question 10

When do you operate in aortic regurg?

Answer 10

When EF<50%

Question 11

What is the priamry cause of Mitral stenosis

Answer 11

RF

Question 12

What is characteristic about mitral regurg disease progress?

Answer 12

Disease of plateaus of about 10 years

Question 13

What are signs of mitral regurg>

Answer 13

Mitral facies on cheeks
AF
haemoptysis due to pulmonary vessels rupturing
Snapping opening click
Sternal heave