valvular disease Flashcards

1
Q

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

A

aortic regurg

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2
Q

Causes

Congenital, bicuspid, rheumatic

A

aortic stenosis

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3
Q

Chest pain, syncope, SOB, CHF, angina

A

aortic stenosis classic traid

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4
Q
No carotid upstroke
Delayed peripheral impulses
Displaced apical pulse
SEM crescendo decrease high pitched RUSB
No S2
S4
A

aortic stenosis

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5
Q

Avoid hypotension

A

aortic stenosis

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6
Q

mercedes sign

A

aortic stenosis

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7
Q

gold std forcath

A

aortic stenosis and pulm htn

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8
Q

SBE PPX

A

mitral stenosis

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9
Q

Congenital (MC), carcinoid, RV outflow obstruction

A

pulm stenosis

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10
Q
PE
Systolic crescendo decrescendo mr over 3rd and 4th intercostal space
Palpable thrill, RV heave
Split S2
Jvd
RHF
A

pulm stenosis

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11
Q

Cause
MCC dilation of valve ring from pulm HTN or dilation of pulm artery
Acquired from infective endocarditis, carcinoid, RH dysplasia

A

pulm regurg

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12
Q

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

A

pulm regurg

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13
Q

JVD, diastolic MR over LLSB (3rd or 4th intercostal space)
Opening snap
Systemic venous congestion
No orthopnea

A

tricuspid stenosis

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14
Q

AR trmt

A

Vasodilators (conflicting)
AVR
Immediate if acute

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15
Q

as trmt

A
Statin
Avoid hypotension
Percutaneous valvuloplasty
TAVR
AVR
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16
Q

PS trmt

A

Balloon valvuloplasty trmt of choice

Replace valve

17
Q

gram steel murmur

A

pr

18
Q

pr trmt

A

Usually dont repair

Treat underlying disease of pulm HTN

19
Q

ts trmt

A

Balloon valvuloplasty

Valve replacement with bioprosthesis

20
Q

tr trmt

A
No trmt if no pulm HTN
Diuretics
Dec afterload
Fix leaflets if damaged
Repair tricuspid
21
Q

_____ MR are always pathologic

A

Diastolic

22
Q

Bacterial endocarditis

trmt

A

Get rid of infection quick with ATB
IV PCN, ceftriaxone, gentamicin, vancomycin, rifampin, nafcillin, doxycycline at least 4 wks
No antiplatelets or antithrombins
Surgery if valve is damaged, persistent bacteremia, recurrent emboli
Dental PPX
Prosthetic cardiac valve, previous endocarditis, congenital heart disease, cardiac transplant
Take these meds in order if allergic to the one before it
Oral amoxicillin, IV or IM ampicillin/cefazolin/ ceftriaxone, IV or IM clindamycin

23
Q

“Horseshoe valve”

A

MR

24
Q

Holosystolic MR: blowing, high pitched, heard best at apex
Loud S4 if acute MR
S3 if LV dysfunction

A

MR

25
Q

MR trmt

A

Dec afterload
Treat CHF (RAAS and SNS -> ACEI, ARBs, beta blockers, aldosterone antagonists)
Treat CMP
PCI or CABG if ischemic cause
Cardiac resynchronization therapy (CRT)- BIV device
Ring repair/annuloplasty ring
Mechanical or bioprosthetic MVR

26
Q

MVP trmt

A

Reassurance
No SBE
Beta blockers if palpitations

27
Q

RHD MCC

A

MS

28
Q

Facial flush

A

MS

29
Q

MS trmt

A
SBE PPX if valve area less than 1.5 cm or rheumatic involvement
Diuretics
Treat AFib
Beta blockers, anticoag
No vasodilators
Valvuloplasty
Commisurotomy or MVR
30
Q

no vasodilators

A

MS