Valvular heart disease Flashcards
Physical exam findings of mitral stenosis x5
Loud S1
Palpable P2
Opening snap after s2
Murmur low pitched and mid-late diastolic rumble
Signs of pulmonary congestion - SOB, PND, hemoptysis, orthopnea
Management of symptomatic mitral stenosis x2
- Percutaneous balloon valvotomy
- Valve replacement
CXR features of mitral stenosis x4
Pulmonary congestion
Enlargement of LA
Right chamber enlargement
Pulmonary hemisiderosis
Causes of mitral regurgitation x5
Rupture chordae tendinea
Dysfunction of papillary muscle
Rheumatic disease
Previous endocarditis
Myoxamatous floppy valve
Clinical presentation of acute and chronic mitral regurgitation x5
Acute- pulmonary edema, low CO
Chronic - pansystolic murmur, radiating to axilla, louder with expiration
CXR findings for M Regurgitation x3
- Pulmonary artery enlargement
- Left atrial enlargement
- Cardiomegaly
Management of MR x2
Medical- diuretics
Valve repair
Causes of aortic stenosis x4
Unicuspid valve
Bicuspid valve
Calcified valve
Degenerative calcific valve- aortic sclerosis
Clinical features and exam findings of aortic stenosis x5
Parvus et tardus ie slow rising carotid pulse
Crescendo decrescendo murmur
Angina, SOB, dizziness and syncope
Valvular and aortic cause of aortic regurgitation x6
Valvular- RHD, bicuspid valve, previous endocarditis
Aortic- dissection, syphilis and Marfan syndrome
Characters of pulses in aortic R x2
Abnormal bounding pulses
Widened pulse pressure
Murmur characteristics in aortic R x3
At Erb’s point
Early diastolic
Loudest on expiration- ask patient to lean forward
Acquired causes of tricuspid vale disease x5
Left HD
Endocarditis
Pulmonary HTN
Radiation
Trauma
Management of tricuspid valve disease x2
Medical- diuretics
Valve repair or replacement
Causes of pulmonary regurgitation
Previous endocarditis
Pulmonary hypertension
Previous pulmonary valve surgery
Indications for antibiotic prophylaxis in pulmonary valve disease x5
Prosthetic valves
Previous infective endocarditis
Congenital cyanotic heart diseases
Unrepaired or incompletely repaired valve
Any valve disease in a transplanted heart
Procedures where prophylaxis is needed x4
Dental procedures
Respiratory tract procedures
Procedures on infected skin
Procedures on GIT/UTI infections
Consider surgery in pulmonary valve disease if (3)
Poor exercise intolerance
Progressive RV dilatation
Right ventricular systolic EF <40%
Prophylactic antibiotics used in Pulmonary VD x5
Amoxicillin 2mg IV
Cephalexin 500mg IV stat
Azithromycin 500mg IV stat
Clarithromycin 500mg IV stat
Clindamycin 900mg IV stat
Clinical presentation of tricuspid regurgitation
Signs of right heart disease ie
1. Ascites
2. Hepatomegaly
3. Raised JVP
4. Right sided S3
5. Right ventricular heave
