valvular dz & endocarditis Flashcards

1
Q

these are causes of what valvular heart dz

supravalvular, subvalvular, valvular (bicuspid, rheumatic, senile degeneration)

A

aortic stenosis

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2
Q

what is the most common cause of aortic stenosis

A

senile degeneration

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3
Q

these are causes of what valvular heart dz

  • can be from aortic root (marfans, ehlers-danlos, syphilis, dissection, etc) or the valve itself
  • causes include endocarditis, dissection, trauma
A

aortic insufficiency

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4
Q

acute vs chronic aortic regurg (in terms of compliance & filling pressure)

A
  • acute– LV non complaint + volume overload, diastolic pressure increases
  • chronic– slow LV dilation w/ long asymp. period; ventricle complaint, near normal filling pressure
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4
Q

acute vs chronic aortic regurg (in terms of compliance & filling pressure)

A
  • acute– LV non complaint + volume overload, diastolic pressure increases
  • chronic– slow LV dilation w/ long asymp. period; ventricle complaint, near normal filling pressure
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5
Q

which valve dz is this

Almost always caused by rheumatic heart dz; sx many years after initial episode of rheumatic fever

A

mitral stenosis

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6
Q

Systolic buckling of the mitral valve leaflets into the L atrium; can result in mitral regurgitation

A

MVP

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7
Q

this is the etiology of what valve dz (from review sesh)

MVP w/ chordal rupture
endocarditis w/ leaflet destruction
papillary muscle dysfunction or rupture after MI

A

acute MR

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8
Q

this is the etiology for what valve dz

primary regurg– MVP, endocarditis
secondary/functional regurg– leaflet tethering or mitral valve annulus diltation, dilated cardiomyopathy

A

chronic MR

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9
Q
  • syncope, angina, exertional dyspnea/CHF/decreased functional capacity (don’t need to have all three sx to send for surgery)
  • soft or absent S2; pulsus parvus et tardus
A

AS

intensity does not correspond w/ severity; where it peaks does

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10
Q

these are sx of what

  • Acute– few PE findings; murmur soft or nonexistent; sx of underlying process predominate
  • Chronic– wide pulse pressure; water hammer pulse; deMusset sign (head bob w/ each heart beat), quincke’s pulse (capillary pulsations in fingertips or lips), laterally displaced PMI
A

sx of AR

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11
Q

these are sx of what

  • Acute– few PE findings; murmur soft or nonexistent; sx of underlying process predominate
  • Chronic– wide pulse pressure; water hammer pulse; deMusset sign (head bob w/ each heart beat), quincke’s pulse (capillary pulsations in fingertips or lips), laterally displaced PMI
A

sx of AR

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12
Q

these are sx of what

  • exertional dysnea, afib
  • low pitched mid-diastolic murmur w/ opening snap
A
  • Sx of mitral stenosis
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13
Q

these are sx of what

  • Acute– tachycardia, HF, hemodynamic shock, Pulmonary edema on CXR, murmur may be soft or inaudible, S3 often present
  • Chronic– holosystolic murmur best heard at the apex
A

sx of MR

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14
Q

midsystolic click followed by a late apical systolic murmur

A

MVP

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15
Q

which valve dz has 2-3 yr mortality of 90% After sx occur

A

aortic stenosis

16
Q

which murmur radiates to L axilla vs carotids

A
  • AS to carotids
  • MR to axilla
17
Q

MR and MS cuddling

A

LLD position for MR and MS

18
Q

listen to which two conditions at left sternal border

A
  • aortic regurg
  • hypertropic cardiomyopathy
19
Q

listen to which three conditions at apex

20
Q

harsh/rumbling sounds should make you think of

21
Q

Caused by group A strep; acute febrile illness 2-4 wks after an episode of pharyngitis

A

rheumatic fever

22
Q

what determines mild vs moderate vs severe valvular disease?

23
Q

when do you tx AS and what is the treatment

A
  • refer for AVR once symptomatic
24
which two valve dz requires emergent surgery when acute?
aortic & mitral regurgitations
25
which valve d/o is it that when severe & symptomatic can be treated with valve replacement & also percutaneous valvotomy
mitral stenosis
26
list the 3 sx of severe aortic stenosis
* syncope * angina * DOE
27
what two findings is the biggest red flag for endocarditis
mumur + infectious symp. also oslor nodes, janeway lesions, splinter hemorrhages
28
3 populations at risk for endocarditis
* central lines or indwelling catheters * IV drug user * artificial valves/severe valve d/o
29
how many blood cultures are needed to dx endocarditis
2
30
gold standard imaging for endocarditis
TEE
31
which 4 patient groups need abx before dental work
1. prosthetic heart valves/valve repair 2. h/o endocarditis 3. transplant pt w/ valve dz (immunocompromised) 4. some congenital heart dz-- unrepaired congential
32
Infection of the endocardium (inner lining of heart chambers and valves) when bacteria/fungus spreads through the bloodstream and attaches to damaged areas of the heart
endocarditis
33
1st line abx in endocarditis
amoxicillin PO
34
3 alternative 1st line abx for endocarditis if PCN allergic
* cephalexin * azithro or clarithromycin * doxycycline
35
3 IM/IV abx for endocarditis
* ampicillin * cefazolin or ceftriaxone * vancomycin