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Cardio 2 > valvular heart disease > Flashcards

valvular heart disease Flashcards

1
Q

mean right atrial pressure

A

0-5

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2
Q

right ventricular pressure

A

25/5

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3
Q

most common cause of tricuspid stenosis in US

A

carcinoid

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4
Q

carvallos sign

A

right side murmurs louder on inhalation

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5
Q

a

A

atrial contraction

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6
Q

x

A

atrial relaxation

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7
Q

v

A

atrial filling

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8
Q

y

A

atrial emptying

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9
Q

cannon A waves

A

tricuspid stenosis also causes blunted y descent

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10
Q

tricuspid stenosis Tx

A

diuretics torsemide, spirolactone(for ascites)

baloon, or bioprostetic

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11
Q

prominent cV wave

A

tricuspid regurg

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12
Q

tricuspid regurg Tx

A

treat primary issue: LV failure or pulmonary HTN

true valvular defect, then use bioprosthetic valve

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13
Q

causes of tricuspid regurg

A 
RV dilation (pulmonary HTN)
pulmonic regurg
LV failure
inherent valvular problems
pacemaker catheter injury
endocarditis
MI
sarcoid
RV dysplasia
FenPhen
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14
Q

high pressure PI

A

prolonged RV systole w/split S2 from pulmonary HTN
graham steell murmur
treat by treating pulmonary HTN

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15
Q

low pressure PI

A

very little murmur

watch carefully

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16
Q

mitral valve stenosis on echo

A

honey stick

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17
Q

mitral valve stenosis venous curve

A

high LV wave

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18
Q

mitral valve stenosis of CX

A

straightening of left heart border

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19
Q

mitral stenosis auscultory findings

A 
loud S1 (unless calcified)
opening snap (unless calcified) 
rumbling diastolic murmur
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20
Q

syndromes of mitral stenosis

A

mild-moderate w/early pulmonary edema

severe w/bpulmonary HTN right CHF, AF, and low CO

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21
Q

Graham steell murmur

A

at left sternal border from relative PI

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22
Q

Mitral stenosis on EKG

A

neg P wave in V1

RAD

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23
Q

mitral stenosis Tx

A

ECHO evaluation scoreing system 8 or less- vavuloplasty

8-10 needs mechanical or bioprosthetic valve

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24
Q

S3

A

marker for severe mitral regurg

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25
Q

pansystolic murmur causes

A

VSD
mitral regurg
tricuspid regurg

26
Q

what lab might reveal onset of CHF

27
Q

What is the effect of handgrip on mitral regurg murmur

A

causes blood to backup -> louder

28
Q

what is the effect of squatting on mitral regurg murmur

A

increased backup and increased pre-load -> louder

29
Q

mitral regurg EKG

A

LVH, LAH or AF

30
Q

differentiate sudden onset MR from chronic MR

A

sudden- high LA pressure

chronic- dilated LA w/normal pressure

31
Q

sudden MR causes

A

papillary m dysfunction
ruptured chordae
infective endocarditis w/valve perforation

32
Q

chronic MR

A

LA and LV enlargement seen on CXR

33
Q

venous curve MR

34
Q

Tx MR

A

failing heart yields decreased EF (40mm)

needs surgery even when asymptomatic

35
Q

ERO

A

effective regurgitant ofrifice
>40
seen in asymptomatic severe MR patients
may show as exercise induced pulmonary HTN on ECHO

36
Q

MR surgery

A

repair if no calcification in annulus or valve, ERO >40 and chordae can be maintained
if not replacement

37
Q

things that make mitral prolapse murmur lounder and longer

A

standing
valsavla
amyl nitrate

38
Q

mitral prolapse associated w/

A

aortic root disease
may be part of hyperadrenergic syndrome in young females
myxomatous degeneration
atrial and ventricular arrhythmias

39
Q

myxomatous degeneration

A

marfans, ehlers danlos,

associated w/aortic regurg

40
Q

mitral prolapse Tx

A

beta blockers

mitral valve repair or replacement

41
Q

gallaverdin phenomenon

A

apex murmur increases after ectopic beat and decreases w/squatting

42
Q

syncope due to aortic stenosis

A

peripheral vasodilation due to high ventricular pressures stimulating baroreceptors in LV
reduced afterload -> increased SV, but that cannot occur due to aortic stenois so BP falls and patient passes out

43
Q

aortic stenosis EKG

A

LVH and LAH

44
Q

peak valvular gradient

A

when it reaches 64 can cause LV failure, angina, or syncope

45
Q

aortic stenosis treatment percautions

A

crossing arotic vavle w/cath for CAD can induce cardiogenic shock, pulmonary edema, stroke or death
nitrates also dangerous

46
Q

parvus et tardus

A

aortic stenosis

47
Q

low gradient, low flow aortic stenosis with reduced EF

A

failure as a result of increased afterload or another cardiac contractility problem from IHD, MI, fibrosis, or other cardiomyopahty

48
Q

Dx and Tx of aortic stenosis

A

dobutamine ECHO

<20% increase in SV = no muscle reserve do not replace valve

49
Q

BNP and aortic stenosis

A

poor prognosis >550 regardless of result of dobutamine echo

50
Q

treating young aortic stenosis

A

percutanesou vavluloplasty

51
Q

treating old aortic stenosis

A

bovine valve

52
Q

middle aged aortic stenosis Tx

A

mechanical plus anticoagulation
may need root replacement
transcutaenous aortic vavle replacement , but associated w/strokes

53
Q

causes of wide pulse pressure

A 
aortic regurg
atherosclerosis
AV fistula
thryrotoxicosis
anemia
fever 
heart block
54
Q

alfred mussets

A

nodding of head w/heart beat

55
Q

corrigans pulse

A

large carotid pulse

56
Q

duroziers pulse

A

diastolic murmur over femoral a on distal pressure

57
Q

light house

A

major flushing w/heart beat

58
Q

HIlls

A

systolic BP in LL >UL by 20

59
Q

quinckes

A

pulsatile blanching and reddening of nail w/slight pressure applications

60
Q

austin flint murmur

A

a low-pitched r murmur at cardiac apex.
systolic
associated with severe aortic regurgitation

61
Q

absent M1

A 
aortic insuffiency
aortic dissection
endocarditis
HTN
inflammatory disease
62
Q

Tx of aortic insufficiency

A

BNP >130 for surgical indication

EF50mm

Cardio 2 (17 decks)

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