Valvular Dz Flashcards
Murmur assoc c:
1) Congenital abnormality
2) 2/2 rheumatic fever
3) Calcified
AS
AS Sxs
CHF (2 yrs)
Syncope (3 yrs)
Angina (5 yrs)
A. fib (6 yrs)
AS Signs
Slow rising, prolonged pulse (Pulsus parvus et tardus) Narrow pulse pressure Harsh crescendo/decrescendo syst eject Radiates to carotids LV heave, LVH, weak S2 +/- S4
AR Signs
Widened pulse pressure (Water-Hammer, Quinke’s); BOUNDING pulse 2/2 overload
S3 common
Early decrescendo diastolic
Shifting PMI
MR Sxs
Hemoptysis (2/2 inc pulm press)
Hoarseness (2/2 atrium on recurr laryng n.)
DOE, Orthopnea, Pulm edema, angina
MR Signs
F>>>M Opening snap Diastolic apical rumble Pulm HTN / edema (2/2 elevated LA press) Atrial arrhythmias - A. fib
MC sustained rhythm in adults Inc c age Can cause clot / embolus (stroke) Reduces CO May be 2/2 valvular dz, thyroid disorder
A. fib
High risk clot formation (A. fib)
HTN LVE > 75 Rheumatic MV Prosthetic valve
Medium risk clot formation (A. fib)
DM
CAD
Tx MS
Tx A. fib (anticoag, dig)
Surgery
New murmur + febrile =
= MR until proven otherwise 2/2 infective endocarditis
Etiology (MR)
1) Acute - infective endocarditis, chordae tendonae rupture, papillary muscle isch/inf
2) Chronic - rheumatic, congenital, calcified annulus
MVP
MC cause is MR
Myxomatous changes (? Marfans)
Mid systolic Click from floppy valve
MR Signs
Acute: Pulm edema
Chronic: LVH, Pulm HTN, A. fib
Loudest in APEX, radiates to AXILLA
Handgrip maneuver - what does this do to the body and how does it affect murmurs
Inc periph resistance
Inc regurg (AR, MR)
Dec AS
