Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Circulation Part 2 > Valvular disease- Bricks > Flashcards

Valvular disease- Bricks Flashcards

1
Q

Aortic stenosis occurs when _

A

Aortic stenosis occurs when aortic valve leaflets become stiff and are unable to fully open –> makes it difficult for the heart to pump blood to the rest of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The 3 cardinal signs of aortic stenosis are:

A

The 3 cardinal signs of aortic stenosis are:
1. Angina
2. Syncope
3. Dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What makes aortic stenosis angina unique?

A

Angina induced by aortic stenosis may present without coronary artery disease
* It is rather caused by a high myocardial oxygen demand since we need to generate really high pressures in the LV to pump blood through the stenotic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The three most common causes of aortic stenosis are:

A

The three most common causes of aortic stenosis are:
1. Degenerative calcifications (aka dystrophic calcification)
2. Congenital bicuspid valve
3. Rheumatic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Aortic stenosis can lead to _ heart failure

A

Aortic stenosis can lead to diastolic heart failure
* High LV pressure –> concentric hypertrophy –> Diastolic HF
* Associated with S4 heart sound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Aortic stenosis has _ S2 sounds

A

Aortic stenosis has single S2 because the aortic valve closure is very delayed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Aortic stenosis is associated with _ murmur best heart over _ region

A

Aortic stenosis is associated with harsh crescendo-decrescendo systolic ejection murmur best heart over second ICS at the URSB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Aortic stenosis murmur is best heard in the aortic region but will also radiate to the _

A

Aortic stenosis murmur is best heard in the aortic region but will also radiate to the carotid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Aortic stenosis murmurs will be louder with:
(Increased/Decreased) prelod
(Increased/Decreased) afterload
(Inspiration/Expiration)

A

Aortic stenosis murmurs will be louder with:
Increased preload
Decreased afterlod
Expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Right sided murmurs are louder on (inspiration/expiration)

A

Right sided murmurs are louder on inspiration
* Because during inspiration we increase venous return to the RA –> increases RV preload –> makes the murmur louder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Left sided murmurs are louder on (inspiration/ expiration)

A

Left sided murmurs are louder on expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Another sign of aortic stenosis is _ , a dulled, delayed carotid pulse; this occurs becuase _

A

Another sign of aortic stenosis is pulsus parvus et tardus , a dulled, delayed carotid pulse
* This occurs because it takes longer to complete LV contraction and close the aortic valve
* The carotid upstroke is delayed after the S2 heart sound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Draw the expected PV loop in aortic stenosis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is volume depletion or vasodilation so dangerous for patients with AS?

A

Because patients with AS are preload dependent
* Their stenosis already decreases the SV
* Therefore, they are especially preload dependent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Squatting (increases/decreases) preload

A

Squatting increases preload
* Increases afterload too

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Passive leg raise (increases/decreases) preload

A

Passive leg raise increases preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Valsalva and standing both _ preload

A

Valsalva and standing both decrease preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

(Systolic/Diastolic) murmurs are almost always abnormal

A

Diastolic murmurs are almost always abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Dystrophic calcification is (normal/abnormal) valve + (normal/abnormal) calcium

A

Dystrophic calcification is abnormal valve + normal calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Metastatic calcification is (normal/abnormal) valve + (normal/abnormal) calcium

A

Metastatic calcification is normal valve + abnormal calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Aortic regurgitation is a condition in which _

A

Aortic regurgitation is a condition in which the heart’s aortic valve does not close tightly and blood travels back from the aorta into the LV
* This occurs during diastole (so both the aortic valve and the mitral valve will be open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Aortic regurgitation may not present with noticeable symptoms (acute cases more likely symptomatic because there is no time for the body to compensate)

A

Sx (acute aortic regurgitation):
* Exertional dyspnea
* Pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Aortic regurgitation is often caused by _ which can either be secondary to acute conditions like _ or chronic conditions like _

A

Aortic regurgitation is often caused by aortic dilatation which can either be secondary to
* Acute conditions like dissection, aneurysm or
* Chronic conditions like Ehlers-Danlos, Marfans, syphilis, hypertension

24
Q

Aside from diseases of the aortic root (dilations), aortic regurg can also be caused by _

A

Aside from diseases of the aortic root (dilations), aortic regurg can also be caused by diseased aortic leaflets
* Calcified valves from old age
* Bicuspid aortic valve
* Rheumatic fever

25
Q

LVEDV (increases/decreases) in aortic regurgitation

A

LVEDV increases in aortic regurgitation

26
Q

To compensate for the increased LVEDV in aortic regurg, _ occurs

A

To compensate for the increased LVEDV in aortic regurg, we get eccentric hypertrophy –> Systolic HF –> S3

27
Q

Increased pulse pressure and “water hammer pulse” describes _

A

Increased pulse pressure and “water hammer pulse” describes aortic regurgitation

28
Q

Head bobbing is associated with _

A

Head bobbing is associated with aortic regurgitation

29
Q

With aortic regurgitation, we expect to hear a _ murmur

A

With aortic regurgitation, we expect to hear an early decrescendo diastolic murmur

30
Q

Aortic regurgitation is best heard at the _

A

Aortic regurgitation murmur is best heard at the left 3rd intercostal space (Erb’s point)

31
Q

Like other regurgitation murmurs, aortic regurgitation will be louder with
_ preload
_ afterload

A

Like other regurgitation murmurs, aortic regurgitation will be louder with
Increased preload
Increased afterload
(also louder on expiration)

32
Q

Mitral stenosis is _

A

Mitral stenosis is narrowing of the mitral valve, restricting blood flow from LA –> LV

33
Q

The most common symptoms of mitral stenosis are _ and _

A

The most common symptoms of mitral stenosis are exertional dyspnea and pulmonary edema due to pulmonary hypertension and decreased cardiac ouput
* Can also present with hoarseness, dysphagia
* Loud S1

34
Q

Causes of mitral stenosis:

A

Causes of mitral stenosis:
* Rheumatic heart disease
* Congenital mitral stenosis
* Mitral annular calcification
* Radiation

35
Q

As a result of mitral stenosis _ will dilate and _ pressure will increase

A

As a result of mitral stenosis left atrium dilates and PCWP increases

36
Q

A serious complication that occurs from the left atrial dilation seen in mitral stenosis is _

A

A serious complication that occurs from the left atrial dilation seen in mitral stenosis is atrial fibrillation, thrombus, stroke

37
Q

Mitral stenosis presents with _ murmur

A

Mitral stenosis presents with diastolic murmur with an opening snap and low-pitched rumble

38
Q

The mitral stenosis murmur is best heard at _ location

A

The mitral stenosis murmur is best heard at apex (left 5th ICS midclavicular line)
* It radiates to the axilla

39
Q

What is the most common cause of mitral stenosis?

A

The most common cause of mitral stenosis is rheumatic fever
* The mitral valve is the most common valve affected by RF

40
Q

Rheumatic fever is an inflammatory condition that can develop after inadequate treatment of _

A

Rheumatic fever is an inflammatory condition that can develop after inadequate treatment of streptococcal pharyngitis or scarlet fever caused by GAS

41
Q

In severe mitral stenosis, the stenotic valve will obstruct blood flow into the LV and _ preload, SV and CO

A

In severe mitral stenosis, the stenotic valve will obstruct blood flow into the LV and decrease preload, SV and CO

41
Q

Patients with mitral stenosis will be put on _ to control heart rate and if they have atrial fibrillation they will be put on _

A

Patients with mitral stenosis will be put on beta blockers to control heart rate and if they have atrial fibrillation they will be put on warfarin

42
Q

Mitral valve prolapse occurs when _

A

Mitral valve prolapse occurs when mitral leaflets balloon into the left atrium during systole

43
Q

Mitral valve prolapse is usually caused by _

A

Mitral valve prolapse is usually caused by myxomatous degeneration, an excess of disorganized connective tissue in the valve leaflets –> degeneration
* Puts increased tension on chordae and papillary muscles

44
Q

The main sign associated with mitral valve prolapse is _

A

The main sign associated with mitral valve prolapse is mid-systolic click with late systolic crescendo
* The mid-systolic click comes from the tensing of the chordae

45
Q

The mid-systolic click in mitral prolapse is best heard over the _

A

The mid-systolic click in mitral prolapse is best heard over the apex

46
Q

Mitral prolapse is unique in that the murmur is louder with _

A

Mitral prolapse is unique in that the murmur is louder with decreased preload
* Think HOCM

47
Q

Four associations with mitral valve prolapse

A

Mitral valve prolapse is associated with:
1. Marfans
2. Papillary muscle rupture
3. Infective endocarditis
4. Rheumatic heart disease

48
Q

The most common right heart valve abnormality is _

A

The most common right heart valve abnormality is tricuspid regurgitation

49
Q

Tricuspid regurgitation is commonly associated with _

A

Tricuspid regurgitation is commonly associated with infective endocarditis from IV drug use
* Note that infective endocarditis most commonly affects the mitral valve but in endocarditis caused by IV drug use it affects tricuspid valve more commonly

50
Q

The most common pathogen associated with infective endocarditis from IV drug use is _

A

The most common pathogen associated with infective endocarditis from IV drug use is s. aureus

51
Q

Tricuspid regurgitation causes volume overload of the right heart which results in the eventual _

A

Tricuspid regurgitation causes volume overload of the right heart which results in the eventual dilation of right ventricle –> right heart failure
* Sx: hepatomegaly, ascites, peripheral edema

52
Q

Tricuspid regurgitation presents with a _ murmur

A

Tricuspid regurgitation presents with a holosystolic murmur at left 4th ICS

53
Q

Another association with tricuspid regurgitation is _ , a high level of serotonin that induces fibrous tissue deposits in the heart valves

A

Another association with tricuspid regurgitation is carcinoid syndrome , a high level of serotonin that induces fibrous tissue deposits in the heart valves
* The lung inactivates the vasoactive substances before they can cause left heart damage

54
Q

What changes do we see in the jugular venous waveform in tricuspid regurgitation?

A

Disappearance of the x descent with giant c-v wave fusion

Circulation Part 2 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions