Valvular Heart Disease Flashcards
What are the 4 main valvular lesions?
Aortic stenosis
Aortic regurgitation
Mitral stenosis
Mitral regurgitation
Which 2 valves open during systole?
Aortic and Pulmonary
Which 2 valves open during diastole?
Mitral and Tricuspid
Which valvular lesions can be heard during systole?
Aortic stenosis
Mitral regurgitation
Which valvular lesions can be heard during diastole?
Aortic regurgitation
Mitral stenosis
What are the 2 main causes of aortic stenosis?
Rheumatic heart disease
Congenital mitral stenosis
What are 4 clinical manifestations of mitral stenosis?
Dyspnoea Haemoptysis Chest Pain Hoarseness Systemic embolisation Infective Endocarditis
What are 3 signs of aortic stenosis you could find on examination?
Mitral facies JVP (prominent a-wave) Apex beat - tapping and diastolic thrill RV heave Diastolic murmur between S2 and S1
What 2 non-imaging investigations would be done to identify valve lesions?
ECG
Cardiac catherisation
What 3 imaging investigations would be done to identify valve lesions?
CXR
ECHO cardiogram
Cardiac MRI
What 2 types of drug are used to treat mitral stenosis?
Diuretics
Anti-coagulation drugs (especially AF related ones)
What 2 surgical interventions can be performed on mitral stenosis?
Valvotomy (balloon or surgical)
Mitral valve replacement
What are 3 causes of mitral regurgitation
Rheumatic Heart Disease
Mitral valve prolapse
Infective endocarditis
What are the 3 clinical manifestations of acute mitral regurgitation?
Breathlessness
Pulmonary oedema
Cardiogenic shock
What are the 3 clinical manifestations of chronic mitral regurgitation? (and the 2 further manifestations due to AF)
Fatigue
Exhaustion
Right heart failure
(Dyspnoea or palpitations)
What are 5 observations you would make upon examination of a patient with mitral regurgitation?
Pulse - reduced in heart failure JVP - prominent in RH failure Apex beat - brisk and hyper-dynamic RV heave Systolic murmur - between S1 and S2
What 2 drugs should been given to treat acute mitral regurgitation?
Dobutamine
IABP
What 2 surgical interventions can be performed on mitral regurgitation?
Mitral valve apparatus repair
Mitral valve replacement
What are the 2 causes of aortic stenosis?
Rheumatic - commissures fuse
Atherosclerosis of the cusps
What is symptomatically significant about aortic stenosis?
It has a low asymptomatic phase
What are 4 cardinal symptoms of aortic stenosis?
Chest pain
Syncope
Breathlessness on exertion
Heart failure
What are 5 observations you would make upon examination of a patient with aortic stenosis?
Pulse - small volume and slow rising JVP - prominent in RH failure Apex beat - vigorous and sustained RV heave Systolic murmur
What treatment do you give to a patient with aortic stenosis?
No treatment unless they develop heart failure
What 2 surgical interventions can be performed on aortic stenosis?
Aortic valve apparatus repair
Aortic valve replacement
What 4 conditions can cause aortic regurgitation?
Marfans syndrome - dilated aorta Hypertension - dilated Aorta Connective tissue disorders Bicuspid aortic valve Rheumatic heart disease Endocarditis
What is symptomatically significant about aortic regurgitation?
Long asymptomatic phase
What is a clinical manifestation of chronic aortic regurgitation?
Breathlessness on exertion
What are 4 observations you would make upon examination of a patient with aortic regurgitation?
Pulse - large volume and collapsing
Wide pulse pressure
Apex beat - displaced and hyper-dynamic
Diastolic murmur
What treatment can be given to delay timing for surgical intervention of aortic regurgitation?
Vasodilator therapy
What 2 surgical interventions can be performed on aortic regurgitation?
Aortic valve apparatus repair
Aortic valve replacement
