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Cardiovascular > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

when do patient with valvular heart disease characteristically get symptoms?

A

on exertion

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2
Q

how do you describe a murmur?

A 
systole or diastole?
what type of murmur?
where is it loudest?
where does it radiate to?
what grade of murmur?
is it influenced by respiration?
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3
Q

what 4 murmurs are systolic?

A

mitral regurgitaiton
tricuspic regurgitation
aortic stenosis
pulmonary stenosis

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4
Q

what 4 murmurs are diastolic?

A

mitral stenosis
tricuspid stenosis
aortic regurgitaion
pulmonary regurgitation

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5
Q

what is a pansystolic murmur?

A

equal throughout systole

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6
Q

what are pansystolic murmurs the result of?

A

regurgitation of blood flow

mitral/tricuspid regurgitation

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7
Q

what are ejection systolic murmurs?

A

during systole sound gets louder than softer

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8
Q

what are ejection systolic murmurs the result of?

A

stenosis

aortic/pulmonary stenosis

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9
Q

what type of murmurs radiate?

A

systolic murmurs

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10
Q

what is an early diastolic murmur?

A

aortic/pulmonary regurgitation

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11
Q

what is a mid diastolic murmur?

A

mitral/tricuspid stenosis

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12
Q

which murmurs are always pathological?

A

diastolic murmurs

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13
Q

where do aortic systolic murmurs radiate to?

aortic stenosis

A

neck

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14
Q

where do pulmonary systolic murmurs radiate to?

pulmonary stenosis

A

left shoulder

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15
Q

where do tricuspid systolic murmurs radiate to?

tricuspid regurgitation

A

dont radiate

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16
Q

where do mitral systolic murmurs radiate to?

mitral regurgitation

A

under left axilla

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17
Q

describe murmur grading?

A
  1. very quiet
    2/3. loud without thrill
    4/5. loud with thrill
  2. loud- audible without stethoscope
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18
Q

which sided murmurs will vary with inspiration?

A

right sided murmurs will be louder on inspiration than expiration

(eg tricuspid and pulmonary murmurs will vary with inspiration)

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19
Q

what are the 3 characteristics of an innocent murmur?

A
  • everything else is normal
  • occurs in early systole
  • usually located in pulmonary area but no where else
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20
Q

what is valve stenosis?

A

valves dont open properly

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21
Q

what is valve regurgitation?

A

valves don’t stay closed properly

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22
Q

what is mixed valve disease?

A

valves neither open properly or close properly

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23
Q

what are the 3 main causes of aortic stenosis?

A

congenital bicuspid aortic valve
age-related calcification
rheumatic

24
Q

what are the symptoms of aortic stenosis?

A

breathlessness
chest pain
dizziness/syncope on exertion

25
Q

what are the signs of aortic stenosis?

A
  • low volume pulse
  • forceful apex- LV heave
  • ejection systolic murmur which is maximal in aortic area and radiates to the carotids
26
Q

what are the 3 treatment options for aortic stenosis?

A
  • surgery: valve replacement
  • balloon aortic valvotomy
  • transcatheter aortic valve implantation
27
Q

what are the 2 types prosthetic heart valves?

A

mechanical

bioprosthetic

28
Q

what are the advantages and disadvantages of mechanical heart valves compared to bioprosthetic?

A

mechanical have long term durability but need anticoagulants

biporsthetic dont need anticoagulants but aren;t as durable

29
Q

what are 4 problems can cause mitral regurgitation?

A

problems with mitral valve leaflets
chordal rupture
ischamia or infarction of papillary muscle
annular dilation

30
Q

why does annular dilation cause regurgitation?

A

because valves no longer meet in the middle so are leaky

31
Q

what 3 things can cause problems with mitral valve leaflets and so cause mitral regurgitation?

A
  • rheumatic heart disease
  • myxomatous degeneration (floppy mitral valve syndrome)
  • endocarditis
32
Q

what are the symptoms of mitral regurgitation?

A

breathlessness
ankle swelling
fatigue

33
Q

what are the signs of mitral regurgitation?

A
  • displaced apex beat

- pansystolic murmur which is maximally heard at the apex and radiated to the axilla

34
Q

what is a sign of mitral regurgitation on a cxr?

A

cardiomegaly

35
Q

what are the treatment options of mitral regurgitation?

A

drugs
surgery
percutaneous mitral valve repair

36
Q

what are the 2 drugs that can be used for mitral regurgitation?

A

diuretics

ACE inhibitors

37
Q

what are the 2 surgery options of mitral regurgitation?

A

valve repair

valve replacement

38
Q

what are the causes of mitral stenosis?

A

rheumatic heart disease (although past history my be absent)

congenital

39
Q

what are the symptoms of mitral stenosis?

A

breathlessnes
tiredness
palpitations

40
Q

what are the signs of mitral stenosis?

A
  • malar flush
  • tapping apex beat
  • mid diastolic murmur localised to apex
  • right heart failure in later stages
41
Q

what valvular heart murmur is most likely to give you palpitations?

A

mitral stenosis

42
Q

what valvular heart murmur is most likely to give you AF?

A

mitral stenosis

43
Q

what are the signs of mitral stenosis on a CXT?

A

straight left heart border

because left atrium enlarges

44
Q

what are the 3 treatment options for mitral stenosis?

A

drugs
surgery
mitral balloon valvuloplasty

45
Q

what drugs are given in the treatment of mitral stenosis?

A

diuretics (for oedema) betablockers, digoxin, warfarin (for AF)

46
Q

what type of surgery is used in mitral stenosis?

A

valve replacement

47
Q

when is mitral balloon valvuloplasty suitable for the treatment of mitral stenosis?

A

if there is a pliable competent valve

48
Q

what are the causes of aortic regurgitation?

A

defect with the aortic leaflets

defects with the annulus

49
Q

what can cause problems with the aortic leaflets?

A

infective endocarditis
connective tissue disease
rheumatic heart disease

50
Q

what can cause problems with the aortic annulus?

A

marfans syndrome

acute aortic dissection

51
Q

what are the symptoms of aortic regurgitation?

A

breathlessness
chest pain
dizziness

52
Q

what are the signs of aortic regurgitation?

A

collapsing pulse
displaced apex
early diastolic murmur heard maximally in the tricuspid area

53
Q

what are the treatment options of aortic regurgitation?

A

drugs

surgery

54
Q

what drugs are used in the treatment of aortic regurgitation?

A

ACEI
ARB
diuretics

55
Q

what surgery is used in the treatment of aortic regurgitation?

A

valve replacement

Cardiovascular (12 decks)

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