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Cardiovascular system > Valvular heart disease > Flashcards

Valvular heart disease Flashcards

1
Q

What are some common symptoms of valvular heart disease?

A

Crushing chest pain that radiates to the arm or jaw
Breathlessness on exertion
Ankle swelling
Orthopnoea
Paroxysmal Nocturnal Dyspnoea
Collapse

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2
Q

What is a cardiac murmur?

A

The audible turbulence of blood flow

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3
Q

What are the 2 main causes of murmurs?

A

Stenosis (valve too narrow)
Regurgitation (valve leaks)

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4
Q

What causes the first heart sound?

A

The closure of the Mitral and Tricuspid valves

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5
Q

What causes the second heart sound?

A

The closure of the aortic and pulmonary valves

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6
Q

When is a systolic murmur heard?

A

Between S1 and S2

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7
Q

When is a diastolic murmur heard?

A

After S2 and before the next S1

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8
Q

Which conditions cause a systolic murmur?

A

Aortic stenosis
Mitral regurgitation

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9
Q

Which conditions cause a diastolic murmur?

A

Mitral stenosis
Aortic regurgitation

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10
Q

What is heard in patent ductus arteriosus upon auscultation?

A

A constant murmur

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11
Q

What is meant by a pansystolic murmur?

A

A murmur of constant volume that stretches across the whole length of systole

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12
Q

What is meant by an ejection systolic murmur?

A

A murmur that quickly gets loud and then dies down over the course of systole

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13
Q

What are the 2 types of systolic murmurs?

A

Pansystolic murmur
Ejection systolic murmur

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14
Q

What are the 2 types of diastolic murmurs?

A

Early diastolic murmur
Mid-diastolic murmur

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15
Q

What is meant by an early diastolic murmur?

A

A murmur at the start of diastole that starts loud and descendos

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16
Q

What is meany be a mid diastolic murmur?

A

A murmur that starts midway through diastole and crescendos to the end of diastole

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17
Q

How are murmurs graded?

A

I - Very quiet
II - Quiet but easy to hear
III - Loud
IV - Loud with a thrill
V - Very loud with a thrill
VI - Audible without a stethoscope

18
Q

How does inspiration affect right sided murmurs?

A

Right sided murmurs are louder upon inspiration

19
Q

What are some common conditions that cause cardiac murmurs?

A

Innocent murmur
Mitral regurgitation
Aortic stenosis
Aortic regurgitation
Mitral stenosis
Continuous murmur
Tricuspid regurgitation

20
Q

What are the characteristics of an innocent murmur?

A

Soft (Less than 3/6 grading)
Early diastolic
Only heard in one location

21
Q

What are the main causes of aortic stenosis?

A

Degenerative - Age related
Congenital (e.g. bicuspid valve not tricuspid)
Rheumatic

22
Q

What are some common symptoms of aortic stenosis?

A

Breathlessness on exertion
Chest pain
Dizziness

23
Q

What causes chest pain in aortic stenosis?

A

Blood cannot flow into the coronary arteries as it is forced at high pressures
Also the increased strain on the heart increases oxygen demand

24
Q

What are the clinical signs of aortic stenosis?

A

Low volume pulse as less blood is being pumped out
Pressure build up in the left ventricle causes hypertrophy, which displaces the apex
Ejection systolic murmur
Radiation to the carotid arteries
Loudest in aortic area

25
Q

Where does the murmur of aortic stenosis radiate to?

A

The carotid arteries

26
Q

What are the 2 types of valve replacement?

A

Mechanical
Bio-prosthetic

27
Q

What are the pros and cons of mechanical valves?

A

They last a very long time, however, they require lifetime warfarin treatment

28
Q

What are the pros and cons of bio-prosthetic valves?

A

They are formed of pig tissue and only last 10 years, however, they do not require warfarin treatment

29
Q

What are the treatment options for aortic stenosis?

A

Conventional valve replacement
Trans-catheter Aortic Valve Implantation (TAVI)
Balloon aortic valvotomy

30
Q

What are the causes of mitral regurgitation?

A

Leaflet prolapse
Rheumatic
Myxomatous (Floppy) valve
Endocarditis
Chordae rupturing
Papillary muscle rupturing
Annular dilatation

31
Q

What are some symptoms of mitral regurgitation?

A

Breathlessness on exertion
Peripheral oedema
Fatigue

32
Q

What are the clinical signs of mitral regurgitation?

A

Pansystolic murmur
radiates to the axilla
Loudest in the mitral area
Can lead to cardiomegaly

33
Q

What are the treatment options for mitral regurgitation?

A

Diuretics
Heart failure medication
Repair - Prolapse
Replace - Degenerative
Percutaneous clipping of annulus

34
Q

What are the causes of mitral stenosis?

A

Most commonly rheumatic (Rheumatic fever)
Very rarely will be congenital

35
Q

What are the symptoms of mitral stenosis?

A

Breathlessness
Fatigue
Palpitations (Atrial Fibrillation)

36
Q

What are the clinical signs of mitral stenosis?

A

Malar flush - Plum red cheeks
Tapping apex beat
Mid diastolic rumbling murmur
Localised to the apex
Straight left border on CXR due to left atrial hypertrophy

37
Q

What are the treatment options for mitral stenosis?

A

Diuretics
Treatment for AF
Valve replacement
Balloon valvuloplasty

38
Q

What are some causes of aortic regurgitation?

A

Endocarditis
Connective tissue damage
Rheumatic
Annulus dilatation
Marfan’s syndrome
Aortic dissection

39
Q

What is the main symptom of aortic regurgitation?

A

Breathlessness

40
Q

What are the clinical signs of aortic regurgitation?

A

Collapsing pulse
Displaced apex due to left ventricular dilatation
Early diastolic murmur at the left sternal edge
Cardiomegaly on CXR

Cardiovascular system (45 decks)

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