Valvular Heart disease Flashcards
What happens to the AV pressure gradient during mitral stenosis?
It increases
What happens to the LV pressure and systolic function in mitral stenosis?
Stays the same
What happens to the RHS of the heart during mitral stenosis?
It dilatates
What are the main signs for mitral stenosis?
Malar flush (due to decreased CO) Tapping apex beat RV heave Increased JVP Rumbling mid-diastolic murmur
What are the main symptoms of mitral stenosis?
Dyspnoea
Chest pain
Haemoptysis
What are the tests used to diagnose mitral stenosis?
ECG (would show RVH)
CXR (left atrium enlargement)
Echocardiography (Thickening and scarring of valve leaflets shown)
What is the management suggested for mitral stenosis?
Diuretic (Get rid of H2O, reduce BP)
Restrict Na+ intake
Mitral valve replacement
Valvotomy
In acute mitral regurgitation, what happens to the end systolic pressure and volume?
Both decrease
On examination in a patient with mitral regurgitation, what will be shown?
Prominent JVP
Hyperdynamic apex beat
RV heave
Loud systolic murmur
What are the main investigations for mitral regurgitation?
ECG (LVH)
CXR (Big LA and LV, mitral valve calcification and pulmonary oedema)
Echo (assesses LV function)
What are the main symptoms of mitral regurgitation?
Dyspnoea
Fatigue
Palpitations
IE
What is the recommended management for mitral regurgitation?
Control rate if fast AF
Anticoagulation (If embolism, prosthetic valve)
Diuretics (Improve symptoms)
Valve replacement
What are the main causes of aortic stenosis?
Calcification
Rheumatic Heart Disease
What are the main clinical symptoms of aortic stenosis?
Angina
Syncope
Heart failure
What would be found upon examination of someone with aortic stenosis?
Prominent JVP
Aortic thrill
Ejection systolic murmur
RV heave
What investigations would you do for someone who you suspect has aortic stenosis?
ECG (ST/T changes)
CXR (Calcification of the AV node)
Cardiac catheterisation
What is the recommended management for someone with aortic stenosis?
Prompt valve replacement (As prognosis not good)
What are the 2 anatomical parts that can have a problem that could cause aortic regurgitation?
The aorta
The aortic valve leaflets
As blood volume leaks back into the left ventricle in someone with aortic regurgitation, what happens to the LVEDV and LV systolic pressure?
Both increase
What happens to the LV physically during aortic regurgitation?
Dilatation and hypertrophy occurs
What is the main, defining feature of aortic regurgitation?
Breathlessness (dyspnoea, orthopnea and paroxysmal nocturnal dyspnoea)
On examination, with someone who has aortic regurgitation, what would be found?
Collapsing pulse
Wide pulse pressure
Displaced and hyperdynamic apex beat
Early diastolic murmur (On expiration, patient sitting forward)
Which investigations would you do for someone you suspect to have aortic regurgitation?
ECG (LVH)
Echo (LV dilatation and hypertrophy)
CXR (Cardiomegaly, dilated ascending aorta, Pulmonary oedema)
What is the recommended management for aortic regurgitation?
Vasodilator therapy
Aortic valve replacement
