valvular dz Flashcards
regurg = ____ overload
volume
stenosis = ____ overload
pressure
regurg = ____ hypertrophy
eccentric
stenosis = ____ hypertrophy
concentric
AS and MR = ___ murmur
systolic
AR and MS = ____ murmur
diastolic
presenting symptoms AS
SAD - syncope, angina, dyspnea
presenting symptoms MS
pulm congestion & Afib
presenting symptoms MR
DOE, paroxysmal nocturnal dyspnea, Afib
presenting symptoms AR
severe pulm edema and CHF
regurg you want the HR to be
fast
stenosis you want the HR to be
slow
which lesions respond to changes in loading conditions
regurg
most common cause of AS
bicuspid aortic valve
which condition produces a hypertrophied LV muscle mass
AS
how to manage aortic stenosis
slow, full, and tight
most important goal in AS
normal HR. [increase preload, avoid hypotension]
causes of AR
rheumatic heart disease, endocarditis, dexfenfluramine
how to manage regurg
full, fast , forward
what factors contribute to reduced coronary perfusion pressure in patients with aortic regurg
lower diastolic pressure and increased LVEDP
how to manage HR and BP in severe AR
normal to fast HR, avoid incrase in BP, avoid increase in SVR
most common cause of MS
rheumatic
pathophys of MS
overloaded LA, underloaded LV. atrial remodeling and increased PVR
goal for mitral stenosis
slow, full , constricted
hemodynamic goals for mitral stenosis
decrease HR, maintain preload, dec PVR, maintain afterload.
mitral valve replacement you will expect to see an ___ in post-op LVEF after valve procedure ?
EF decreased
pathophys MR
backward flow from LV to LA causes inc LA volume and pressure and that increases LVEDV
goals for MR
full, fast, forward.
BP goal for MR
maintain… hypertension is avoided
increased SVR causes ___ regurg and ___ forward flow
increased, decreased
what is hypertrophic cardiomyopathy
increase in the size and mass of the involved ventricle.
what is systolic anterior motion of the mitral valve ?
LV outflow tract is occluded….. blood is ejected into the LV outflow tract at high velocity which creates venturi effect. this pulls the anterior leaflet of the mitral valve toward the septum during systole. this creates dynamic outflow tract obstruction and mitral regurg.
what makes SAM better
vasoconstrictors and volume expansion
