valvular disease Flashcards
Wide pulse pressure, hammer pulse, muller sign (uvula), quinke sign (nail beds), de musset sign (head bob)
PMI enlarged and laterally displaced
No S1, S4, blowing and mid to late diastolic decrescendo mr, austin fline mr
aortic regurg
Causes
Congenital, bicuspid, rheumatic
aortic stenosis
Chest pain, syncope, SOB, CHF, angina
aortic stenosis classic traid
No carotid upstroke Delayed peripheral impulses Displaced apical pulse SEM crescendo decrease high pitched RUSB No S2 S4
aortic stenosis
Avoid hypotension
aortic stenosis
mercedes sign
aortic stenosis
gold std forcath
aortic stenosis and pulm htn
SBE PPX
mitral stenosis
Congenital (MC), carcinoid, RV outflow obstruction
pulm stenosis
PE Systolic crescendo decrescendo mr over 3rd and 4th intercostal space Palpable thrill, RV heave Split S2 Jvd RHF
pulm stenosis
Cause
MCC dilation of valve ring from pulm HTN or dilation of pulm artery
Acquired from infective endocarditis, carcinoid, RH dysplasia
pulm regurg
Diastolic mr over 3rd and 4th intercostal space
Split S2
Gram steel mr- high pitched blowing decres diastolic mr after P2 with pulm systolic pressure over 70 mmHg
pulm regurg
JVD, diastolic MR over LLSB (3rd or 4th intercostal space)
Opening snap
Systemic venous congestion
No orthopnea
tricuspid stenosis
AR trmt
Vasodilators (conflicting)
AVR
Immediate if acute
as trmt
Statin Avoid hypotension Percutaneous valvuloplasty TAVR AVR