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Cardiovascular > Valvular Disease > Flashcards

Valvular Disease Flashcards

1
Q

why do murmurs occur

A

due to turbulent flow

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2
Q

what are types of systolic murmurs

A

pan systolic and ejection systolic

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3
Q

what are types of diastolic murmurs

A

early or mid diastolic

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4
Q

True/False…

aortic murmurs radiate to axilla

A

False…
mitral murmurs radiate to axilla
aortic murmurs radiate to carotid

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5
Q

what are the Qs to ask yourself if murmur present?

A
  1. systolic/diastolic
  2. type of murmur (e.g. pan-systolic)
  3. which of 4 valve areas
  4. radiates to where
  5. grading?
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6
Q

what are the signs of valvular disease?

A

apex beat abnormalities
parasternal heave
murmurs
heart sounds

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7
Q

what abnormalities may be seen with apex beat?

A

tapping apex= mitral stenosis
displaced & diffused apex= LV dilation
displaced & heaving= LVH

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8
Q

what does a parasternal heave signify?

A

RV overload (cor pulmonale/ PHT)

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9
Q

when does a 3rd heart sound occur?

A

after 2nd HS

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10
Q

why does 3rd HS occur

A

due to large amount of blood striking a very compliant left ventricle

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11
Q

when does 4th heart sound occur in respect to 1st and 2nd HS?

A

before 1st HS.

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12
Q

why does 4th heart sound occur?

A

when blood strikes a non compliant LV (LV is floppy)

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13
Q

Which is a physiological heart sound and often occurs in children?

A

3rd HS

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14
Q

what are the 4 classes of murmur

A

aortic stenosis, aortic regurgitation

mitral stenosis, mitral regurgitation

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15
Q

what does stenosis mean

A

valves don’t open properly

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16
Q

what does regurgitation mean

A

valves don’t close properly

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17
Q

True/False…

you can get mixed valve disease

A

True…

this means you get both stenosis and regurgitation

18
Q

recap: when does 1st HS occur

A

closure of mitral & tricuspid valve during systole

19
Q

recap: when does 2nd HS occur

A

closure of aortic and pulmonary valves at start of diastole

20
Q

what triggers symptoms in valvular HD?

A

exertion

21
Q

what are causes of aortic and mitral stenosis/regurg. ?

A

congenital (e.g. patent ductus arteriosis, VSD/ASD), rheumatic, degenerative, ischaemic, infective (endocarditis)

22
Q

what are some presenting symptoms of murmurs?

A

breathless*, chest pain, syncope, palpitations

23
Q

what’s a unique symptoms of mitral regurg?

A

peripheral oedema

24
Q

what are signs of Aortic stenosis?

A

weak pulse, displaced apex, ejection systolic murmur, heard in carotids, 4th HS

25
Q

signs of AR?

A

collapsing pulse, large pulse pressure, displaced apex, early diastolic murmur at left sternal edge

26
Q

signs of MS?

A

malar flush, tapping apex beat, mid diastolic murmur at apex

27
Q

signs of MR?

A

displaced apex, pan systolic murmur that radiates to axilla

28
Q

ix for AS?

A

ECG (shows LVH, LBBB), echo

29
Q

ix for AR?

A

CXR, Echo (cardiomegaly)

30
Q

ix for MS?

A

CXR (straight left heart border), Echo

31
Q

ix for MR?

A

CXR (cardiomegaly), Echo

32
Q

tx for AS

A

aortic valve replacement, TAVI, balloon aortic valvotomy

33
Q

what is a TAVI?

A

trans-catheter aortic valve replacement

34
Q

what is tx for AR?

A

ACEI, valve replacement

35
Q

what is tx for MS?

A

diuretics, ACEI, valve replacement, balloon valvotomy

36
Q

tx for MR?

A

diuretics, ACEI, valve replacement or repair if prolapse

37
Q

what is a mitral valve prolapse?

A

when the leaflets stick upward into LA causing a clicking murmur

38
Q

prosthetic heart valves given to…

A

young due to longevity but warfarin has to be taken

39
Q

bio-prosthetic valve given to…

A

older people as usually last 10 years but no warfarin

40
Q

what is a good acronym to remember for valvular disease?

A

MRS ASS
Mitral Regurgitation Systolic
Aortic Stenosis Systolic

Cardiovascular (12 decks)

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