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Cardiology > Valvular Disease > Flashcards

Valvular Disease Flashcards

1
Q

What creates the first heart sound?

A

Mitral and tricuspid valves closing

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2
Q

What creates the second heart sound?

A

Aortic and pulmonary valves closing

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3
Q

When is a systolic murmur heart?

A

Between S1 and S2

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4
Q

When is a diastolic murmur heard?

A

After S2

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5
Q

Where do you auscultate the aortic valve?

A

Right, 2nd/3rd intercostal space

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6
Q

Where do you auscultate the pulmonary valve?

A

Left, 2nd/3rd intercostal space

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7
Q

Where do you auscultate the tricuspid valve?

A

Left sternal border

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8
Q

Where do you auscultate the mitral valve?

A

Apex

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9
Q

Which murmur classically radiates to the carotids?

A

Aortic stenosis

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10
Q

Which murmur classically radiates to the axilla?

A

Mitral regurgitation

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11
Q

What are some of the presenting features with a murmur?

A

Reduced functional capacity –> exertion symptoms are characteristic of valvular disease

  • chest pain
  • SOB
  • collapse
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12
Q

What are the invasive and non invasive options for investigating a murmur?

A

Non invasive - Echo

Invasive - cardiac catheterisation

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13
Q

What type of murmur is aortic stenosis?

A

Ejection systolic

Radiates to carotids

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14
Q

How would you describe the pulse in aortic stenosis?

A

Slow rising

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15
Q

What are some causes of aortic stenosis?

A

Degenerative (age related)
Congenital - bicuspid valve
Rheumatic

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16
Q

What are the treatment options for aortic stenosis?

A

Conventional valve replacement
TAVI - trans catheter aortic valve implantation
Balloon aortic valvotomy (BAV)

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17
Q

What are the two types of prosthetic heart valves?

A

Mechanical e.g. metal

Bio-prosthetic e.g. pig valve

18
Q

Which type of prosthetic valve is best in younger patients and why?

A

Mechanical –> lasts longer

19
Q

Which type of prosthetic valve is best in older patients and why?

A

Bio-prosthetic –> have to take warfarin

only lasts 10 years

20
Q

When would TAVI be used over conventional valve replacement surgery?

A

If significant co-morbidites meaning surgery not possible

surgery favoured otherwise

21
Q

What type of murmur is mitral regurgitation?

A

Pansystolic

Radiating to the axilla

22
Q

What are some of the clinical features of mitral regurgitation?

A

SOB
Peripheral oedema
Fatigue
Displaced apex

23
Q

Which structural abnormality is often seen with mitral regurgitation?

A

LV dilatation

24
Q

How is mitral regurgitation managed?

A

Medication –> treat HF

Surgery –> repair/replace

25
Q

What is the most common cause of mitral stenosis?

A

Rheumatic fever

26
Q

What type of murmur is mitral stenosis?

A

Mid-diastolic rumbling murmur

Localised to apex

27
Q

What are some signs of mitral stenosis?

A

Malar flush

Tapping apex beat

28
Q

What are some causes of aortic regurgitation?

A

Leaflets:

  • endocarditis
  • connective tissue disease
  • rheumatic

Annulus:

  • Marfan’s
  • aortic dissection
29
Q

What is the main symptom in aortic regurgitation?

A

SOB

30
Q

What type of murmur is aortic regurgitation?

A

Early diastolic murmur

at left sternal edge

31
Q

What is the best way to hear aortic regurgitation?

A

Sit forward and hold breath on expiration

32
Q

What type of pulse would you expect in aortic regurgitation?

A

Collapsing

33
Q

What are the treatment options for aortic regurgitation?

A

Medication: ACE inhibitors
Surgery: if symptoms + LV dilatation
–> valve replacement

34
Q

What does the murmur sound like in a PDA?

A

Machine like

35
Q

Which murmur does infective endocarditis most commonly cause?

A

Aortic regurgitation

36
Q

What type of murmur is tricuspid regurgitation?

A

Loud pan systolic

37
Q

Which murmur causes a slow rising pulse?

A

Aortic stenosis

38
Q

Which murmur causes a collapsing pulse?

A

Aortic regurgitation

39
Q

What is pulsus paradoxus and what might cause it?

A

Decrease in BP on inspiration –> weaker pulse

Tamponade or constrictive pericarditis

40
Q

What is pulsus alterans and what causes it?

A

Alternating strong and weak pulses

Indicated severe LV systolic dysfunction –> severe HF

41
Q

What might you find on examination of pulses in someone with Takayasu’s arteritis?

A

Absent pulses

Cardiology (14 decks)

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