Valvular Disease Lecture Poweroint

Question 1

Aortic stenosis under the age of 30 is likely due to…

Answer 1

….a bicuspid aortic valve

Question 2

Risk factors for aortic stenosis are the same as….

Answer 2

…for atherosclerosis

Question 3

Aortic stenosis key physical exam finding description

Answer 3

-Harsh systolic ejection murmur heard best at aortic area often radiating to the neck, sometimes accompanied by S4 and often associated with pulsus parvus et tartus measured at the carotid

Question 4

Acute vs chronic aortic regurgitation

Answer 4

• Acute usually caused by endocarditis or a staph infection
• chronic is often caused by diseases affecting the aortic root (marfan syndrome) or valve leaflets (rheumatic fever for example)

Question 5

Most common cause of mitral stenosis

Answer 5

Rheumatic heart disease

Question 6

Mitral stenosis key physical exam finding description

Answer 6

Opening snap after S2 and high pitched murmur heard best at the apex

Question 7

Mitral stenosis leads to…

Answer 7

…atrial dilation (not hypertrophy, can lead to hoarsness)

Question 8

Aortic stenosis leads to…

Answer 8

…LVH

Question 9

Aortic regurgitation leads to….

Answer 9

….ventricular dilation

Question 10

Midsystolic click is diagnostic of…

Answer 10

…mitral valve prolapse

Question 11

Most common cause of mitral regurgitation

Answer 11

Mitral valve prolapse

Question 12

Holosystolic murmur audible at apex and axilla indicates…

Answer 12

…mitral regurg

Question 13

1st and 2nd most common reasons for valve surgery

Answer 13

aortic stenosis

mitral regurgitation

Question 14

Acute mitrla regurg

Answer 14

Occurs with papillary muscle rupture with MI causing sudden onset of heart failure and pulmonary congestion

Question 15

Surgical repair for mitral regurg should occur before…

Answer 15

…symptoms develop to prevent irreversible LV damage

Question 16

Why would a Transesophageal echo be preferred over a transthoracic?

Answer 16

In a patient we want to cardiovert immediately, we can confirm there is no clot very quickly to ensure cardioversion is a safe choice to not dislodge an embolism

Question 17

5mg twice a day pradaxa key advantage

Answer 17

no pt inr monitoring to ensure anticoagulant therapy is working

Question 18

Nondihydropine Ca2+ channel blockers are not to be used in…

Answer 18

…heart failure patients

Question 19

2 drugs for heart failure patients

Answer 19

B blockers and ACEI

Question 20

What drug is better for patients with heart failure

Answer 20

B blockers are better than ca2+

Question 21

cardioversion

Answer 21

restoring normal sinus rhythm thru delivering electric shock to heart via chest or medication, preferred is chest

Question 22

Unsynchronized cardioversion is done in…

Answer 22

…cardiac arrest

Question 23

don’t do unsynchronized cardioversion in heart with normal sinus rhythm or else…

Answer 23

…could put into fatal arrhythmia

Question 24

Visible JVP indicates…

Answer 24

…right sided heart failure

Question 25

irregularly irregular rhythm is always…

Answer 25

…afib

Question 26

furosemide (lasix) treats…

Answer 26

..volume overload or edema

Question 27

amiodarone is a ___ stage treatment for afib, vfib, or vtach

Answer 27

end, don’t do it first line ever, rather cardiovert first