valvular heart disease

Question 1

what occurs in acute aortic regurgitation?

Answer 1

sudden increase in LVEDP and LAP acute pulmonary oedema cardiogenic shock

Question 1

Valvular problems - which are systolic and which are diastolic?

Answer 1

AS = systolic murmur AR = diastolic murmur MS = diastolic murmur MR = systolic murmur

Question 2

when do you intervene with a patient who has aortic regurgitation?

Answer 2

before symptoms occur

Question 2

causes of mitral regurgitation

Answer 2

mitral valve prolaspe ruptured chordae tendinae infective endocarditis myocardial infart –> ruptured papillary muslce rheymatic fever collagen vascular disease cardiomyopathy

Question 3

what happens during decompensation from aortic regurgitation?

Answer 3

LVDV increases markedly LV function decreases LV Systolic volume increases there are irreversible changes

Question 3

what other problems can mitral stensosis cause?

Answer 3

AF Thrombus pulmonary hypertension

Question 4

what does aortic regurgitation do?

Answer 4

part of each SV leaks back into LV during diastole LV has to pump greater SV each beat to maintain CO VOLUME OVERLOAD Increased LVEDV, Increased EF, Normal SV

Question 5

what happens in mitral stenosis

Answer 5

pressure gradient across the mitral valve –> reduced filling of the LV –> increased LA pressure and volume

Question 6

What other problems/diseases can mitral regurgitation cause?

Answer 6

AF Thrombus in LA pulmonary hypertension

Question 8

valve stenosis always causes…

Answer 8

restriction of flow —> PRESSURE GRADIENT across the valve Higher pressure in chamber behind valve PRESSURE OVERLOAD

Question 9

when do you intervene with a patient with mitral regurgitation

Answer 9

before symptoms

Question 10

When do you intervene with a patient with mitral stenosis?

Answer 10

at the development of symptoms pulmonary hypertension

Question 11

cause of mitral stenosis

Answer 11

rheumatic fever

Question 11

which valve problem causes a pan-systolic murmur and which causes a crescendo-decrescendo mumur?

Answer 11

pan-systolic = mitral regurgitation crescendo-decrescendo = aortic stenosis

Question 13

what happens during mitral regugitation decompensation?

Answer 13

marked increase in LV diastolic volume reduced EF increased LVSV these are irreversible changes and coincide with symptoms

Question 15

when do you intervene with a patient with aortic stenosis?

Answer 15

at the development of symptoms (SOB, CP, syncope) LV changes usually reverse after surgery

Question 17

Valve incompetence always causes..

Answer 17

blood leaking back into previous chamber INCREASED EJECTION FRACTION VOLUME OVERLOAD

Question 18

pressure change in ventricles and aorta with aortic regurgitation

Answer 18

ventricular and aortic systolic pressure rises aortic diastolic pressure falls –> pulse pressure rises

Question 19

What does aortic stenosis do?

Answer 19

pressure overload of the LV –> concentric hypertrophy –> less compliant –> increased LVEDP required Diastolic dysfunction

Question 20

what happens with mitral regurgitation

Answer 20

portion of SV ejected into LA LV therefore has to pump greater SV for each beat to maintain CO VOLUME OVERLOAD Increased EDV, increased EF, Increased LA volume and P normal LVESV

Question 21

Causes of aortic regurgitation

Answer 21

damaged aortic leaflets (endocarditis, rheumatic fever) aortic root dilated so leaflets don’t close