Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

HA > Valvular dz > Flashcards

Valvular dz Flashcards

1
Q

Valvular heart disease incidence

A

2.5% in US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Valve associated with stenosis and regurg

A

aortic stenosis = also regurgitant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What increases the mortality in pts with regur?

A

CAD w/ mitral or aortic valve disease

Mitral regurgitation d/t ischemic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

New York Heart Association Functional Classification of Patients with Heart Disease

class 1

A

asymtomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

New York Heart Association Functional Classification of Patients with Heart Disease

class 2

A

symptoms with ordinary activity but comfortable at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

New York Heart Association Functional Classification of Patients with Heart Disease

class 3

A

symptoms with minimal activity but comfortable at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

New York Heart Association Functional Classification of Patients with Heart Disease

class 4

A

symptoms at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Murmurs cause

A

-Turbulent blood flow across abnormal valves
-Increased flow across normal valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Functional murmur

A

innocent/physiologic murmur due to a condition outside the heart
pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pahtologic murmur

A

seomthing going on inside the heart itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Identifying characteristics of the murmur

A

Timing of the murmur in the cardiac cycle is most important
location, radiation and intensity.

Midsystolic vs holosystolic and diastolic murmurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

midsystolic murmur

A

can be fucntional murmur

Occur between distinct S1 and S2 heart sounds
Crescendo–decrescendo pattern

hear at R sternal border, if goes to the carotids = aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Systolic murmur

A

Stenosis of the aortic or pulmonic valves
Incompetence of the mitral or tricuspid valves

Midsystolic or holosystolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Holosytolic murmur

A

merges with S1 and S2

best heard at apex and radiates to the axilla = mitral regur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Diastolic murmur

A

Stenosis of the mitral or tricuspid valves
Incompetence of the aortic or pulmonic valves

follows s2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

aortic stenosis murmur location

A

R sternal border

radiates to cartoids, ejection clock, also diastolic murmur if aortic regur is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Aortic regurg murmur location

A

L sternal border

may also have systolic murmur due to increased SV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

mitral stenosis murmur location

A

apex.
opening snap after S2, loud S1, radiation to L axilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

mitral regurg murmur location

A

apex

radiates to the L axila

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Common auscultatory sites

A

Aortic: 2nd ICS RSB
Pulmonic: 2nd ICS LSB

Tricuspid: 5th ICS LSB
Mitral: 5th ICS MCL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Valve disease ekg dx

A

Left atrial enlargement (notched p wave)
Left or right axis deviation (hypertrophy)
Dysrhythmias (afib)
Possible ischemia/previous MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Valve dz cxray

A

Cardiomegaly
Left mainstem bronchus elevation
Valvular calcifications
aortic abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mechanical valves

A

Metal or carbon alloy
Very durable… 20-30 years
Highly thrombogenic
Young pts
hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Bioprosthetic valve

A

Porcine or bovine
Shorter lasting… 10-15 years
Low thrombogenic potential
Elderly pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
DC warfarin
Discontinuation of warfarin for Minor vs major surgery bridge therapy Rebound hypercoagulable state
26
Anticoagulation during pregnancy
Continue but warfarin can lead to spont termination of pregnancy in 2st trimester ASA or lmwh
27
Mitral stenosis
Rare in the US Rheumatic heart disease Primarily affects women Asymptomatic for 20-30 years
28
Normal mitral valve orifice area
Normal mitral valve orifice area is 4–6 cm2 Symptoms develop - < 2 cm2
29
LV contractility remains normal in....
Mitral stenosis
30
MS symptoms
Dyspnea on exertion Orthopnea Paroxysmal nocturnal dyspnea Pulmonary edema Pulmonary HTN Atrial fibrillation
31
MS CXR
Mitral calcification Pulmonary edema or vascular congestion Elevated left main bronchus Straightening of left heart border
32
MS EKG
Notched P waves AFib
33
MS Treatment
Rate control; β-blockers, calcium channel blockers, digoxin Left atrial pressure; Diuretics Anticoagulation - risk of stroke 7-15% per year Arterial thromboembolism vs venous thrombosis surgical correction
34
MS maintains svr and bp using....
Phenylephrine, vasopressin
35
Prevention and treatment of decreased cardiac output or pulmonary edema in MS pts by....
avoiding Excessive pre-op IV fluid or Trendelenburg position
36
Mitral regurgitation
More common than MS 2% of the US population
37
Mitral regurgitation associated with
IHD Ruptured papillary muscle Endocarditis Mitral valve prolapse Cardiomyopathy
38
MR pathophysiology
Left atrial volume overload and pulmonary congestion Transforms LV Eccentric hypertrophy Compliance of left atrium
39
Mr Symptoms
History of IHD, endocarditis, papillary muscle dysfunction Holosystolic murmur at apex Radiates to axilla Cardiomegaly Atrial fibrillation
40
MR EKG
Left atrial and LV hypertrophy Atrial fibrillation
41
MR CXR
Cardiomegaly Left atrial and LV hypertrophy
42
Mr treatment
Asymptomatic vs symptomatic pts MV repair > MV replacement EF < 30% little improvement with surgery Transcatheter mitral valve repair; MitraClip Vasodilators, biventricular pacing; ACE-I, β-blockers (carvedilol)
43
HR for MR
Normal to slightly increased HR avoid Bradycardia – LV volume overload Avoid increased SVR Vasodilators (nitroprusside)
44
Aortic stenosis associated with
Calcific aortic stenosis- leaflets calcify/ get stenotic Bicuspid aortic valve- seen in younger patients (30-50) Develops earlier in life with BAV than with tricuspid aortic valve
45
most common congenital valvular abnormality
bicuspid aortic valve in 1-2% of population
46
normal aortic valve area
Normal valve area 2.5 - 3.5 cm2 Severe AS valve area < 1cm2
47
As pathophysiology
Obstruction to ejection of blood into the aorta Increased LV pressure Always associated with AR Concentric LV hypertrophy- subendocaridal compression
48
As symptoms
Systolic or midsystolic murmur – right upper sternal border Crescendo–decrescendo pattern Radiates to neck, mimics carotid bruit
49
Critical AS
Angina pectoris; Increased risk of peri-op mortality and MI Syncope Dyspnea on exertion - diastolic dysfunction = elevated LV filling pressures
50
AS Symptoms correlate with.....
Symptoms correlate with an average time to death of 5, 3, and 2 years 75% of symptomatic pts die w/in 3 years w/o valve replacement
51
AS cxr
Prominent ascending aorta Aortic valve calcification
52
AS ECG
LV hypertrophy ST Depression T wave inversion
53
AS echo
Tri-leaflet vs bi-leaflet valve Thickened and calcified leaflets Valve area and transvalvular pressure gradients
54
balloon valvotomy done with....
for adolescents/young adults with AS >65 do TAVR
55
CPR is typically not effective with....
aortic stenosis
56
Fluids with AS
Intravascular fluid volume - normal levels Preload dependent
57
tx of hypotension with AS
Hypotension - α-agonists (phenylephrine)
58
tx of Junctional rhythm or bradycardia with AS
- ephedrine, atropine, or glycopyrrolate
59
Tx of tachycardia with AS
Tachycardia - β-blockers (esmolol)
60
Aortic regurgitation caused by
Endocarditis Rheumatic fever Bicuspid aortic valve (BAV) Anorexigenic drugs
61
Acute aortic regurgitation caused by
Endocarditis or aortic dissection
62
AR pathophysiology
Decreased CO d/t regurgitant SV Combined LV pressure and volume overload Usually slow onset
63
Magnitude of aortic regurgitation depends on:
Time available for regurgitant flow (HR) Pressure gradient across the aortic valve (SVR)
64
(Austin-Flint murmur) heard in....
AR Low-pitched diastolic rumble
65
Hyperdynamic circulation causes
Widened pulse pressure Decreased DBP Bounding pulses
66
s/s of LV failure
Dyspnea, orthopnea, fatigue and coronary ischemia
67
AR on EKG/cxr / echo
LV enlargement and hypertrophy Echocardiogram Leaflet prolapse or perforation Associated aortic abnormalities
68
treatment for AR
Decrease systolic HTN, LV wall stress, and improve LV function; Diuretics, ACE-I, CCB Surgical ; AVR, Aortic root replacement
69
AR avoid....
Avoid bradycardia, HR: > 80 bpm Avoid increased SVR Minimize myocardial depression; Inotrope to increase contractility

HA (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions