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
what is the 1st and 2nd most common valvular disease?
AS then MR
where is MR heard?
pansystolic murmur heard at apex radiating into axilla
which sounds are assocaited with MR?
quiet S1
split S2
which type of murmur is heard in MS?
mid-late diastolic murmur (best heard in expiration)
which heart sounds are heard in MS?
loud S1, opening snap
features of pulse in MS?
low volume pulse
signs of MS?
malar flush + AF
CXR results with MS?
length of murmur increases
opening snap becomes closer to S2
