Valvular Heart Disease Flashcards
What heart valves is the S1 heart sound related to?
tricuspid and mitral
What heart valves is the S2 sound related to?
pulmonary and aortic
What is the 3rd heart sound indicative of?
heart failure
Where on the chest would each of the valvular murmurs be heard?
aortic - 2nd intercostal space, right sternal border
mitral - apex area - 5th intercostal space, mid-clavicular line
pulmonary - 2nd intercostal space, left sternal border
tricuspid - 5th intercostal space, left sternal border
What anatomical position is used to listen to the heart sounds S1 and S2?
third intercostal space on left sternal border = Erb’s point
What can valvular heart disease cause?
hypertrophy (thickening of the chamber) or dilation of the myocardium
affects the chamber that comes immediately before the valve
pushing against a stenotic valve means that the heart muscle has to try harder and causes hypertrophy
What does mitral stenosis cause? And what does aortic stenosis cause?
mitral stenosis - left atrial hypertrophy
aortic stenosis - left ventricular hypertrophy
What does mitral regurgitation cause?
left atrial dilatation - when a leaky valve allows blood flow back into a chamber, it stretches the muscle resulting in dilatation
What does aortic regurgitation cause?
left ventricular dilatation
What is aortic stenosis and what is the effect?
narrowing of aortic valve
restricting blood flow from left ventricle to aorta
How is aortic stenosis treated?
valve replacement surgery
What type of murmur does aortic stenosis cause?
ejection systolic high pitched murmur - crescendo decrescendo
What are the clinical signs of aortic stenosis?
thrill
slow rising pulse
narrow pulse pressure
exertion syncope
What causes aortic stenosis?
idiopathic age related calcification
bicuspid aortic valve
rheumatic heart disease
What is aortic regurgitation?
when blood flows back from the aorta to the left ventricle
What are the signs of aortic regurgitation?
early diastolic soft murmur
Austin flint murmur heart at apex
thrill
collapsing pulse - felt on left radial artery
wide pulse pressure
heart failure and pulmonary oedema
What causes aortic regurgitation?
idiopathic age related weakness
bicuspid aortic valve
connective tissue disorders -> Ehlers-Danlos Syndrome or Marfan syndrome
What is mitral stenosis?
restricted blood flow from the left atrium to the left ventricle
what type of murmur is heard in mitral stenosis?
mid diastolic low pitched rumbling murmur
What clinical signs are seen in an examination of a patient with mitral stenosis?
loud S1 sound
tapping apex beat
malar flush - red discolouration of skin on upper cheeks and nose
atrial fibrillation
what causes mitral stenosis?
rheumatic heart disease
infective endocarditis
What is mitral regurgitation?
incompetent heart valve allowing blood to flow back from the left ventricle to the left atrium
What type of murmur is associated with mitral regurgitation?
pan-systolic high pitched whistling murmur
What type of murmur is heard in tricuspid regurgitation? And what abnormal heart sound?
pan-systolic murmur
split 2nd heart sound
What clinical signs are seen in tricuspid regurgitation?
thrill on palpation
raised JVP
pulsative liver
peripheral oedema
ascites
What type of murmur is heard in pulmonary stenosis?
ejection systolic murmurs
