Valvular disease

Question 1

what are the causes of mitral regurgitation?

Answer 1

endocarditis 
post MI 
rheumatic fever 
mitral valve prolapse 
congenital

Question 2

what are the risk factors for mitral regurgitation?

Answer 2

female 
lower BMI 
prior MI
prior mitral regurgitation
prior mitral prolapse 
connective tissue disorder 
renal dysfunction

Question 3

what are the signs of mitral regurgitation on examination?

Answer 3

pan systolic murmur best heard at the apex and radiates to the axilla

quiet S1
widely split S2

Question 4

what are signs of mitral stenosis on examination?

Answer 4

mid-late diastolic murmur heard best during expiration 
loud S1 
low volume pulse 
malar flush 
AF

Question 5

what are features of mitral stenosis on CXR and echo?

Answer 5

CXR - left atrial enlargement

ECHO - cross section of mitral valve < 1 sq cm

Question 6

what are causes of mitral stenosis?

Answer 6

rheumatic fever

rare - carcinoid

Question 7

what are the causes of aortic regurgitation?

Answer 7

valve disease

• rheumatic fever
• endocarditis
• RA, SLE,
• bicuspid aortic valve

aortic root disease

• aortic dissection
• marfans syndrome
• spondyloarhropathies
• syphillis
• hypertension

Question 8

what are signs of aortic regurgitation on examination?

Answer 8

early diastolic murmur best heard when leaning forward and during inspiration

collapsing pulse
wide pulse pressure
quinicke’s sign (nailed pulsation)
de Musset’s sign (head bobbing)

Question 9

what are signs of aortic stenosis on examination?

Answer 9

ejection systolic murmur 
narrow pulse pressure
slow rising pulse 
soft/absent S3
S4
thrill 
LVH

Question 10

what are the main treatment options for valvular disease?

Answer 10

valve replacement
valve repair
balloon valvuloplasty