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Maddy - CPR II - some pharm > Valvular HD and Murmurs > Flashcards

Valvular HD and Murmurs Flashcards

1
Q

stenosis causes ___ by ____

A

causes hypertrophy and HF from pressure overload

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2
Q

regurg causes ___ by ____

A

causes dilation from volume overload

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3
Q

list the systolic murmurs

A 
MR
TR
AS
PS
VSD
ASD
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4
Q

list the diastolic murmurs

A 
AR
MS
PR
TS
Atrial Myxoma
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5
Q

list the 6 grades of murmurs

A
  1. barely audible
  2. faint, soft
  3. louder, easily heard
  4. very loud w/ palpable thrill (vibration)
  5. heart w/ stethoscope barely touching chest w/ thrill
  6. can heart w/o stethoscope or can hear w/ stethoscope close to chest, palpable thrill
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6
Q

acute causes of mitral regurg

A
  • ischemic papillary muscle dysfunction
  • rupture chordal tendinae
  • infective endocarditis
  • volume overload
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7
Q

chronic causes mitral regurg

A
  • MVP
  • myxomatous degeneration
  • mitral annular calcification
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8
Q

PE for mitral regurg

A
  • systolic murmur
  • blowing at apex
  • radiates to left axilla
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9
Q

demographic for MVP

A

females > males 7:1

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10
Q

sx/PE for MVP

A
  • range from asymptomatic to having CP
  • SVT
  • PVCs
  • dyspnea
  • systolic murmur at apex
  • may have click/murmur increase w/ valsalva and standing
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11
Q

how does decreased ventricular volume and chamber size affect MVP murmur

A

increases it

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12
Q

sx of tricupsid regurg

A

asymptomatic

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13
Q

auscultation for tricuspid regurg

A

blowing systolic mumur at 4th ICS LSB, increases on inspiration (Carvallo sign)

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14
Q

when is tricuspid regurg significant

A

when associated w/:

  • pulmonary HTN
  • lung dz
  • RV infarction
  • inferior wall MI
  • pacemaker
  • infectious endocarditis
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15
Q

how does tricuspid regurg affect jugular venous pulse

A

makes prominent V wave

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16
Q

two etiologies of AS

A
  • degenerative calcification

- bicuspid (genetic)

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17
Q

sx AS

A
  • dyspnea
  • angina
  • syncope
18
Q

PE for AS

A
  • harsh systolic mumur, crescendo-decrescendo, 2nd ICS RSB
  • radiates to sternal notch/carotids
  • diminished S2
  • Pulsus parvus et tardus (weak and slow pulse)
  • narrow pulse pressure (140/100)
19
Q

ECG for AS

A

LVH, strain pattern (down sloping of ST segment - T wave)

20
Q

what genetic conditions is bicuspid aortic valve related to

A

marfans, turner’s

21
Q

bicuspid aortic valve sounds to auscultation

A

systolic murmur/click at LSB or apex

22
Q

describe murmur of PS

A

crescendo-decrescendo at 2-3 ICS LSB, radiate to left shoulder and clavicle

23
Q

what congenital defects are associated with tetrology of fallot

A
  • PS
  • VSD
  • RVH
  • overriding aorta
24
Q

auscultatory findings of VSD

A

holosystolic mumur at lower LSB w/ thrill

25
Q

auscultatory findings of ASD

A

systolic mumur upper LSB w/ fixed splitting of S2

26
Q

etiology of MS

A
  • rheumatic heart dz group A strep
  • congenital
  • mitral annular calcification
27
Q

MS leads to ____

A
  • pulm HTN
  • RV failure
  • left atrial enlargement
  • a fib
28
Q

sx MS

A
  • dyspnea
  • orthopnea
  • palpitations
  • hoarseness (compression of recurrent laryngeal n.)
29
Q

PE for MS

A

diastolic murmur, low pitch, rumbling at apex

- increased S1 and S2 followed by opening snap

30
Q

ECG for MS

A
  • LAE if in sinus
  • a fib
  • RV hypertrophy
  • right axis deviation if associated with pulm HTN
31
Q

etiology TS

A
  • rhematic dz**
  • associated with mitral stenosis
  • more common in females
32
Q

auscultatory findings for TS

A

diastolic murmur LSB increases on inspiration (Carvallo sign)

33
Q

effect of TS on jugular venous pulse

A

prominent A wave

34
Q

ECG for TS

A

right atrial enlargement

35
Q

acute causes AR

A
  • infective endocarditis
  • aortic dissection
  • chest trauma
36
Q

chronic causes AR

A
  • calcific degeneration
  • bicuspid aortic valve
  • dilated aortic root
  • rheumatic
37
Q

AR causes ___ from ____

A

causes LVH and LHF from volume overload

38
Q

sx of AR

A

acute: pulmonary edema from infectious endocarditis
chronic: dyspnea, orthopnea, angina

39
Q

ausculatory findings AR

A

diastolic decrescendo murmur 3rd ICS LSB, soft S2

40
Q

PE findings AR

A
  • wide pulse pressure (130/50)
  • DeMusset sign (head bob***)
  • Quincke’s sign (capillary nail pulsations)
  • Traube sign (pistol shot sounds over femoral a.)
  • Duroziez’s sign (diastolic murmur over femoral a. w/ compressed w/ bell)
41
Q

ausculatory findings PR

A

diastolic decrescendo murmur 2nd ICS LSB

42
Q

PR is associated with ___

A

pulm HTN and increased S2

Maddy - CPR II - some pharm (18 decks)

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