valvular diseases Flashcards
1
Q
Causes of AR
A
o Rheumatic fever (commonest)
o Bicuspid valve
o Infective Endocarditis
o Others:
Marfan’s syndrome
Tertiary Syphilis
2
Q
Pathology of AR
A
Reflux of blood from aorta to LV in diastole.
For CO to be maintained, total volume to be pumped into aorta must ↑, therefore LV size must increase.
3
Q
signs and examination of AR
A
Signs:
o Pulse: – Collapsing (wide pulse pressure, WATER_HAMMER
PALPATATIONSSSSS
o Other random:
- Quincke’s sign -* capillary pulsation in the nail beds.
- De Musset’s sign* - head nodding with eachheartbeat.
- Pistol shot femorals -* a sharp bang heard on
auscultation over the femoral arteries in time with
each heartbeat.
Palpation: – Displaced apex beat
Auscultation:
o High-pitched early diastolic murmur best
heard at the left sternal edge in the fourth intercostal space with the patient leaning forward and their breath held in expiration
“lub taaarr”:
