Valvular Heart Disease

Question 1

MC valvular involvement in MV disease

Answer 1

Mitral valve with AR

Question 2

MC congenital heart valve defect

Answer 2

Bicuspid aortic valve

Question 3

Significant AS diameter

Answer 3

Severe less than 1 cm

Question 4

Cause of dyspnea in AS

Answer 4

Elevation of pulmonary capillary pressure

Question 5

Pulsus Parvus et tarsus

Answer 5

AS

Question 6

Double apical impulse (S4)

Answer 6

AS

Question 7

What is the Gallavardin effect and where is it seen?

Answer 7

Murmur in AS Transmitted downward to the apex, where it may be confused with systolic murmur of MR

Question 8

Average time to death after onset of cardinal symptoms

Answer 8

Angina 3
Syncope 3
Dyspnea 2
HF 1.5-2

Question 9

Mutation in bicuspid aortic valve

Answer 9

NOTCH1 gene

Question 10

3 cardinal symptoms of AS

Answer 10

Exertional dyspnea
Angina pectoris
Syncope

Question 11

Pathophy

A wave accentuated in AS

Answer 11

Diminished distensibility of RV caused by the bulging

Question 12

Paradoxical splitting of S2

Answer 12

Aortic stenosis

Question 13

Severe AS size of valve

Answer 13

Severe AS <1 cm area
Mod AS 1-1.5 cm
Mild AS 1.5-2 cm

Question 14

Treatment of aortic stenosis

Answer 14

Avoid strenuous activity
Avoid dehydration and hypovolemic

Station- slows progression of leaflet calcification

Question 15

Etiology of aortic regurgitation

Answer 15

1. Primary valve disease

2. Primary aortic root disease

Question 16

Major hemodynamics compensation for AR

Answer 16

Increase in LV end diastolic volume

Question 17

Wide arterial pulse pressure

Answer 17

Aortic regurgitation

Question 18

What is the Austin flint murmur

Answer 18

Slow putted rumbling mode to late diastolic murmur

Due to anterior leaflet of MV displaced

Question 19

Treatment for AR

Answer 19

IV diuretic and vasodilators
OperAte
Avoid B blockers so as to not reduce CO further

Question 20

First choice any hypertensive agents in AR 🐝

Answer 20

Vasodilators (ACEI, DHP CCB, hydralazine)

DHp nifedipine

Question 21

Hemodynamics hallmark of MS

Answer 21

Abnormally INCREASED AV pressure gradient

Question 22

Austin flint murmur

Answer 22

AR

Question 23

Prominent A waves due to vigorous R atrial systole

Answer 23

MS

Question 24

Accentuated first heart sound

Answer 24

MS

Question 25

Opening snap

Answer 25

MS

Question 26

High pitched diastolic decrescendo murmur blowing

Answer 26

Graham steel of PR

Question 27

Differentiate acute and chronic MR

Answer 27

Acute MR= prominent v wave

Chronic MR= LA v wave less prominent

Question 28

Most characteristic finding in MR

Answer 28

Systolic murmur of III/VI intensity
Most prominent at APEX
Radiates to axilla