Valvular Heart Disease Flashcards
Tapping apex beat
Mitral Stenosis
Displaced and diffused apex beat
LV dilatation
Displaced and heaving
LV hypertrophy
What could cause a parasternal heave?
Cor pulmonale or pulmonary hypertension
Why can a parasternal heave be felt in some patients?
Right ventricular overload
6 questions of murmurs?
- Systole or diastole
- Type
- Where is it loudest
- Radiation
- Grade
- Influence by respiration
Ejection systolic murmur
Aortic stenosis
Pan systolic murmur
Mitral regurgitation
Early diastolic murmur
Aortic regurgitation
Mid diastolic murmur
Mitral stenosis
Radiation to carotids
Aortic stenosis
Radiation to axilla
Mitral regurgitation
How many grades of murmur are there?
6... I = Very quite III = Loud IV = Loud + thrill VI = Audible from end of bed
Which murmurs are louder on inspiration?
Right sided i.e. tricuspid and pulmonary
2nd sound splitting
Aortic stenosis or normal on inspiration
Third heart sound
Aortic regurgitation
Fourth sound
Mitral stenosis
Innocent murmur
Tricuspid regurgitation
Pericardial rub
Mitral regurgitation
Which murmurs are always pathological?
Diastolic
Causes of Aortic Stenosis?
Calcification of aorta due to age
Congenital bicuspid valve instead of tricuspid
Rheumatic fever
Treatment for aortic stenosis?
Conventional valve replacement
TAVI - seen on hospital
Balloon aortic valvotomy
Who should get mechanical valve replacement?
Younger patients - but on lifelong warfarin
Who should get bio-prosthetic valve replacement?
Older patients - last for about 10 years
What causes mitral regurgitation?
Rheumatic
Endocarditis
Papillary/chordae rupture
Annular dilatation
What does myxomatous stand for?
Weakening of the connective tissue
What does mitral regurgitation do to the apex?
Displaces it
Treatment for mitral regurgitation?
Diuretics
Surgery - repair or replacement
What is the main cause of mitral stenosis?
Rheumatic fever
Malar flush
Mitral stenosis
Collapsing pulse
Aortic regurgitation
Slow rising pulse
Aortic stenosis
Treatment for mitral stenosis
Diuretics
Surgery - valve replacement
Balloon valvuloplasty
Causes of aortic regurgitation
Endocarditis Connective tissue disease Rheumatic Marfans Aortic dissection
Treatment for aortic regurgitation
ACE inhibitors
Surgery - valve replacement
