Valvular Emergencies

Question 1

Paradoxical splitting of S2, S3, and S4

Answer 1

AORTIC STENOSIS

Question 2

Presence of “water hammer pulse”

Answer 2

AORTIC REGURGITATION

Question 3

INR required for mechanical mitral valve

Answer 3

INR of 2.5-3.5

INR of 2.0-3.0 for mechanical AORTIC valves

Question 4

True or False

All DIASTOLIC murmurs are pathologic

Answer 4

TRUE

PATHOLOGIC:
•Diastolic murmurs
•New systolic murmurs with symptoms at rest

Question 5

Grade

“LOUD” murmur

Answer 5

Grade 4

Grade
1 - Faint, may not be heard in all positions
2 - Quiet, but heard immediately upon stethoscope placement
3 - Moderately loud
4 - Loud
5 - Heard with steth partly off the chest
6 - Heard when steth is entirely off the chest

Question 6

Classic triad of Aortic Stenosis

Answer 6

Dyspnea
Chest pain
Syncope