Valvular Disorders Flashcards
Most common valvular disease in the US and second most frequent cause for cardiac surgery
Aortic Stenosis
Narrows valve opening, impeding ejection function of the left side of the heart
Aortic Stenosis
Results in volume overloading due to retrograde blood flow into the left ventricle
Aortic insufficiency / regurgitation
Impedes blood flow between left atrium and ventricle
Mitral stenosis
Allows retrograde blood flow and volume overload of left atrium
Mitral insufficiency / regurgitation
Mitral valve prolapse
What does valve-related progressive heart failure lead to?
Pulmonary HTN and congestion
Most frequent causes of mitral and aortic valve disorders
Congenital defects
Other causes of mitral and aortic valve disorders
Rheumatic heart disease
Connective tissue disorders
Infection
Senile degeneration
Most common presenting symptoms of mitral and aortic valve disorder
Dyspnea, fatigue, decreased exercise tolerance
Additional symptoms of mitral and aortic valve disorders
Cough, rales, paroxysmal nocturnal dyspnea, hemoptysis, hoarseness
How would aortic stenosis affect carotid pulse?
Thready (not enough volume being ejected)
How would aortic insufficiency affect carotid pulse?
Bounding pulses, widened pulse pressures (fluid overload)
Most patients with this disorder are thin females with minor chest wall deformities, mid systolic clicks, and late systolic murmur
Mitral Valve Prolapse
Murmur location and quality of Aortic Stenosis
2nd RICS
Loud, harsh, midsystolic
Murmur location and quality of Aortic Regurgitation
2nd-4th LICS
High-pitch blowing, Systolic (soft) and diastolic decrescendo
Murmur location and quality of Mitral Stenosis
Apex (4th-5th LICS) - patient in Left Lateral Position
Low pitch, Middiastolic
Murmur location and quality of Mitral Regurgitation
Apex (4-5th LICS)
Med-High pitch blowing, Pansystolic
Treatment for Mitral / Aortic Valve disorders
Surgical repair / replacement only longterm treatment
Medical treatment options for mitral / aortic valve disorders
- Diuretics / vasodilators for pulmonary congestion
- Digoxin / beta blockers for dysrhythmias
- Anticoagulant therapy to prevent thromboemboli
- Antibiotics to prevent endocarditis (esp for Regurge)
Patients with congenital anomalies of these valves usually present during infancy or childhood; adults may present with stenosis resulting from rheumatic scarring or connective tissue disease
Tricuspid / Pulmonic Valve disorders
Tricuspid regurgitation murmur location / quality
LLSB
Blowing, Pansystolic / Holosystolic
JVP often elevated
Pulmonic stenosis murmur location / quality
2nd-3rd LICS
Harsh, Midsystolic crescendo-decrescendo
Clinical features of pulmonic / tricuspid valve disorders
Patients usually present with exercise intolerance
Right Heart fluid overload: Jugular venous distention, peripheral edema, hepatomegaly
Only definitive means of identifying structural / functional abnormalities in valvular disorders
Transesophageal Echocardiography
Cardiac catheterization as well
Doppler ultrasound for pressure gradient assessment
