Valvular Disease Flashcards
why do murmurs occur
due to turbulent flow
what are types of systolic murmurs
pan systolic and ejection systolic
what are types of diastolic murmurs
early or mid diastolic
True/False…
aortic murmurs radiate to axilla
False…
mitral murmurs radiate to axilla
aortic murmurs radiate to carotid
what are the Qs to ask yourself if murmur present?
- systolic/diastolic
- type of murmur (e.g. pan-systolic)
- which of 4 valve areas
- radiates to where
- grading?
what are the signs of valvular disease?
apex beat abnormalities
parasternal heave
murmurs
heart sounds
what abnormalities may be seen with apex beat?
tapping apex= mitral stenosis
displaced & diffused apex= LV dilation
displaced & heaving= LVH
what does a parasternal heave signify?
RV overload (cor pulmonale/ PHT)
when does a 3rd heart sound occur?
after 2nd HS
why does 3rd HS occur
due to large amount of blood striking a very compliant left ventricle
when does 4th heart sound occur in respect to 1st and 2nd HS?
before 1st HS.
why does 4th heart sound occur?
when blood strikes a non compliant LV (LV is floppy)
Which is a physiological heart sound and often occurs in children?
3rd HS
what are the 4 classes of murmur
aortic stenosis, aortic regurgitation
mitral stenosis, mitral regurgitation
what does stenosis mean
valves don’t open properly
what does regurgitation mean
valves don’t close properly
True/False…
you can get mixed valve disease
True…
this means you get both stenosis and regurgitation
recap: when does 1st HS occur
closure of mitral & tricuspid valve during systole
recap: when does 2nd HS occur
closure of aortic and pulmonary valves at start of diastole
what triggers symptoms in valvular HD?
exertion
what are causes of aortic and mitral stenosis/regurg. ?
congenital (e.g. patent ductus arteriosis, VSD/ASD), rheumatic, degenerative, ischaemic, infective (endocarditis)
what are some presenting symptoms of murmurs?
breathless*, chest pain, syncope, palpitations
what’s a unique symptoms of mitral regurg?
peripheral oedema
what are signs of Aortic stenosis?
weak pulse, displaced apex, ejection systolic murmur, heard in carotids, 4th HS
