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CR2 > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

6 common valve lesions

A

Mitral valve prolapse
Aortic stenosis/
Aortic regurgitation
Mitral regurgitation
Mitral stenosis
Right sided valve lesions

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2
Q

Mitral valve prolapse

A

> /=2mm systolic prolapse of 1 or both vakve leaflets beyond long axis annular plane during 2d echo

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3
Q

What histological changes occur in valves in mitral valve prolapse

A

None

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4
Q

Myxomatous degeneration

A

non-inflammatory progressive disarray of the valve structure caused by a defect in the mechanical integrity of the leaflet due to the altered synthesis and/or remodeling by type VI collagen

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5
Q

Where and when do mitral valve leaflets prolapse into in mitral valve prolapse

A

Left atrium during systole

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6
Q

Mitral valve prolapse symptoms

A

Usually asymptomatic
Chest pain
Atrial arrhythmias

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7
Q

Mitral prolapse signs

A

Ejection click
Late systolic murmur

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8
Q

Aortic stenosis causes

A

Calcification disease
Congenital bicuspid valve
Rheumatic disease

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9
Q

Aortic stenosis symptoms

A

Dyspnoea
Angina
Syncope
Left ventricular failure
Sudden death

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10
Q

Aortic stenosis signs

A

Slow rising carotid pulse
S4
Ejection click
Ejection systolic murmur - diamond

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11
Q

What causes S4 in aortic stenosis

A

Atrium trying to push blood into stiff left ventricle

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12
Q

Why does aortic stenosis cause dyspnoea

A

Increased diastolic pressure in stiff non compliant left ventricle

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13
Q

Why does aortic stenosis and aortic regurgitation cause angina

A

Increased oxygen demand in hypertrophied left ventricle

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14
Q

Why does aortic stenosis cause syncope

A

Paroxysmal ventricular arrhythmias or exertional cerebral hypoperfusion

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15
Q

Why does aortic stenosis cause left ventricular failure

A

Contractile failure as ventricle dilates

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16
Q

How can aortic stenosis causes sudden death

A

Ventricular arrhythmias

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17
Q

Why does aortic stenosis cause high QRS and T inversion on an ECG

A

Left ventricular strain

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18
Q

What valve area shows severe aortic stenosis

A

<1cm2

19
Q

What can aortic valve leaflet disease and aortic root dilating disease cause

A

Aortic regurgitation

20
Q

What can cause aortic valve leaflet disease

A

Calcification disease
Congenital biscuspid valve
Rheumatic disease
Infective endocarditis

21
Q

What can cause aortic root dilating disease

A

Ankylosis spondylitis
Marfan syndrome
Aortic dissection

22
Q

Aortic regurgitation symptoms

A

Often none
Dyspnoea
Angina

23
Q

Aortic regurgitation signs

A

Rapidly rising carotid pulse
Early diastolic murmur
Ejection murmur - possible

24
Q

Why does aortic regurgitation cause Dyspnoea

A

Contractile failure as ventricle dilates

25
Q

What causes the early diastolic murmur in aortic regurgitation

A

Aortic backflow

26
Q

What causes the ejection murmur in aortic regurgitation

A

Turbulent ejection from volume loaded left ventricle

27
Q

What indicates surgery is needed for sortic regurgitation

A

Symptoms of aortic regurgitation
Echocardiograohic evidence of worsening left ventricle dilation

28
Q

Mitral stenosis causes

A

Rheumatic fever

29
Q

Mitral stenosis symptoms

A

Dyspnoea
Orthopnoea
RV failure
Palpitations
Systemic emboli

30
Q

Mitral stenosis signs

A

Atrial fibrillation
Loud s1
Opening snap
Mid diastolic rumble
Pre systolic murmur
Incr JVP
Basal creeps
Ankle oedema

31
Q

WHy does mitral stenosis cause Dyspnoea and Orthopnoea

A

Incr left atrial pressure

32
Q

Why does mitral stenosis cause right ventricular failure

A

Incr left atrial pressure and reactive pulmonary vasoconstriction

33
Q

How does mitral stenosis cause palpitations

A

Atrial fibrillation

34
Q

What does static blood in dilated fibrillating left atrium due to mitral stenosis or regurgitation predispose a patient to

A

Systemic emboli

35
Q

What can be heard in chest auscultation of a patient with mitral stenosis

A

Loud s1
Opening snap
Mid diastolic rumble
Pre systolic murmur

36
Q

How does mitral stenosis affect left atrium pressure

A

Increase

37
Q

What operation can be used to treat mitral stenosis

A

Valvuloplasty

38
Q

What conditions can cause mitral regurgitation

A

Mitral valve leaflet disease
Subvalvar disease
Functional mitral regurgitation

39
Q

Mitral regurgitation symptoms

A

Dyspnoea
Orthopnoea
Palpitations
Systemic emboli
Incr left atrial pressure
Atrial fibrillation
Thrombosis

40
Q

Mitral regurgitation signs

A

Sinus rhythm or atrial fibrillation
Pansystolic murmur
S3
Incr JVP
Basal creeps
Ankle oedema

41
Q

How can mitral how can mitral regurgitation be investigated

A

M-mode echo
M-mode phonogram
M-mode Doppler
Left ventricular angiogram

42
Q

What indicates a patient needs surgery for mitral valve disease

A

Symptoms don’t respond to treatment
Worsening cardiovascular complications

43
Q

Which patients may a Percutaneous MitraClip be used in

A

Patients too sick for heart surgery

44
Q

Valvular heart disease treatment

A

Surgery / valvuloplasty
Diuretics - fluid overload
Digoxin - af
Beta blockers - af
Verapamil - af
Anticoagulants - af

CR2 (33 decks)

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