Valvular disease in detail Flashcards
which type of murmur is seen in aortic stenosis?
ejection systolic murmur (ESM)
which manouvre can reduce aortic stenosis?
valsalva menouvre (breathing out strongly through mouth while holding nose)
what kind of pulse pressure does aortic stenosis has?
narrow and slow rising
S2 in AS
soft / absent
which heart sound can be heard in AS?
S4
which conditions is AS associated with?
left ventricular hypertrophy or failure
what are the 5 causes of AS?
degenerative calcification (old age) bicuspid aortic valve (<65s) william's syndrome post-rheumatic disease subvalvular: HOCM
how to manage AS if asymptomatic
observe
how to manage AS if symptomatic
valve replacement
when to consider surgery for asymptomatic AS
valavular gradient >40 and features such as left ventriculer systolic dysfunction
which type of murmur is heard in aortic regurg?
early diastolic murumr
how is the intensity of AR increased?
handgrip manoeuvre
features of AR pulse
collapsing + wide pulse pressure
which 2 signs can be seen in AR?
Quincke’s sign (nailbed pulsation) + De Musset’s sign (head bobbing)
what can be heard in severe AR and why?
mid-diastolic Austin Flint murmur due to partial closure of the anterior mitral valve cusps caused by the regurgitation streams
