Valvular Heart Disease

Question 1

Symptoms of valvular heart disease

Answer 1

Chest pain, dizziness, breathlessness, characteristically on EXERTION

Question 2

Orthopnea?

Answer 2

Shortness of breath when lying flat

Question 3

Paroxsymal nocturnal dyspnoea?

Answer 3

When SOB wakes person up in the night

Question 4

New York Heart Association Functional Classification

Answer 4

Class I - No limitation
Class II - Slight limitation – ordinary activity
Class III - Marked limitation –less than ordinary activity
Class IV - Severe limitation –minimal activity or at rest

Question 5

Normal position of apex beat?

Answer 5

5th left intercostal space

Question 6

Grading of murmurs

Answer 6

I. Very quiet
II. Quiet but easy to hear
III. Loud
IV. Loud with thrill
V. Loud audible without a stethescope (with thrill)
VI. Loud audible from a distance (with thrill)

Question 7

Causes of aortic stenosis

Answer 7

Congenital (bicuspid)
Old age/degenerative
Rheumatic fever

Question 8

Aortic stenosis on ECG

Answer 8

LVH

Question 9

When would you give TAVI instead of surgery?

Answer 9

Too high risk for surgery
Medical –co-morbidity eg bad COPD, previous stroke
Technical reasons eg prev CABG

Question 10

Myxomatous degeneration

Answer 10

Floppy mitral valve

Question 11

Drugs used to treat mitral regurgitation?

Answer 11

DADW

Diuretics, ACEI’s, Digoxin and Warfarin

Question 12

Main cause of mitral stenosis?

Answer 12

Rheumatic

Question 13

Murmur localised to apex?

Answer 13

Mitral stenosis

Question 14

Cardiac cachexia and right heart failure could develop from what?

Answer 14

Mitral stenosis

Question 15

Drugs used to treat mitral stenosis?

Answer 15

Diuretics, beta blockers, digoxin, warfarin

Question 16

Which part of the heart could marfan’s syndrome and aortic dissection affect?

Answer 16

The annulus, this could then cause aortic regurgitation

Question 17

Drugs used to treat aortic regurgiation?

Answer 17

ACEi’s, angiotensin receptor blockers, diuretics