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Valvular Heart disease Flashcards

1
Q

What is mitral regurgitation?

A

Mitral valve. Regurgitation= valve doesn’t close fully due to increased stretch of papillary muscles.
Effect= BACKFLOW to pulmonary circulation

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2
Q

What is the main cause of Mitral regurgitation?

A

LV dilatation.

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3
Q

Some causes of LV dilatation?

A
  1. Remodelling post acute MI
  2. Dilated cardiomyopathy- ischaemic or non.
  3. Rheumatic fever
  4. Endocarditis
  5. Chordae tendineae
  6. Calcification
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4
Q

Signs + symptoms for M regurgitation?

A
  1. Symptoms
    - Breathlessness
    - Fatigue
    - Pulmonary Oedema
  2. Signs
    - Displaced apex (axilla)
    - Pan systolic murmur
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5
Q

Treatment for M regurgitation?

A
  1. Medication- Diuretics + ACE
  2. Surgical
    Repair- prolapse
    Replacement- degenerative
  3. Percutaneous- infancy clip (fixes hole in heart).
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6
Q

What is mitral stenosis?

A

Tight mitral valve, which doesnt fully open.

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7
Q

Causes of mitral stenosis?

A
  • Reumatic fever

- Endocarditis

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8
Q

Signs + Symptoms for mitral stenosis?

A
  1. Signs
    - Malar flush
    - Tapping apex beat
    - Mid diastolic rumble. localised to apex.
  2. Symptoms
    - Breathlessness
    - Fatigue
    - Pulmonary oedema
    - palpitations
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9
Q

What common heart disease can mitral stenosis be associated with?

A

Atrial fibrillation

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10
Q

Treatment for Mitral stenosis?

A
  1. Medication- diuretics, Treat AF
  2. Surgery- Valve replacement
  3. Percutaneous- balloon valvuloplasty (widening valve using balloon)
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11
Q

What is aortic stenosis?

A

Tight aortic valve, doesn’t fully open.

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12
Q

Main causes for aortic stenosis?

A
  1. Congenital- Bicuspid instead of tricuspid
  2. Age related Calcification
  3. Rheumatic fever
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13
Q

What are the signs and symptoms of it?

A
  1. Signs
    - Low volume pulse
    - Forceful displaced apex
    - Ejection systolic murmur, radiates to carotids.
  2. Symptoms
    S-syncope
    A-angina
    D-dyspnoea
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14
Q

Treatment for aortic stenosis?

A
  1. Medical- diuretics + angina treatment
  2. Surgical- Valve replacement
  3. Percutaneous- balloon valvuloplasty
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15
Q

What is aortic regurgitation?

A

Aortic valve doesnt properly close. Backflow of blood into LV

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16
Q

Causes of aortic regurgitation?

A
  1. Widening/ aneurysmal change of aortic annulus
  2. Endocarditis
  3. Rheumatic fever
17
Q

Signs and symptoms of aortic regurgitation

A
  1. Signs
    - Collapsing pulse
    - Displaced apex
    - Early diastolic murmur, left sternal edge.
  2. Symptoms
    - Breathlessness
    - Syncope/dizziness
    - Fatigue
18
Q

Treatment for aortic regurgitation?

A
  1. Medication- ACE

2. Surgery- Valve replacement.

19
Q

Most common symptoms related to valvular disease?

A
  • Chest pain
  • Dizziness
  • SOB.

Exertional symptoms v common.

20
Q

What are the main clinical signs of Right sided heart failure?

A
  • Raised JVP
  • Pitting oedema
  • Hepatic congestion
21
Q

How does one characterise pitting oedema?

A

Indentation left after applying pressure to skin.

Common areas- ankles, sacrum

22
Q

What is a cardiac murmur?

A

Audible turbulence in blood flow.

23
Q

Checklist to go through when hearing murmurs.

A

need to memorise this.

  • Systolic or diastolic
  • Type of murmur.
  • Where is it loudest
  • Radiating? if yes where to? (either carotid or axilla)
  • Grade of murmur.
24
Q

In relation to heart sounds, when are systolic murmurs heard?

A

Between 1st and 2nd heart sound.

25
Q

What are the two types of systolic murmurs?

A
  1. Ejection- starts quiet, then big sound, then dies down (sidewards diamond shape)
  2. Pan systolic- same sound frequency throughout murmur.
26
Q

What are the two types of diastolic murmurs?

A
  1. Early

2. Mid

27
Q

What are the grades for murmurs?

A 
1- very quiet
2- quiet, easy to hear
3- Loud
4- Loud + thrill
5- V loud + thrill
6- Audible without stethoscope
28
Q

How does inspiration affect murmurs? (L&R)

A

Right sided murmurs louder on inspiration

29
Q

What are the auscultatory sounds for the common murmurs?

A
  1. Aortic stenosis- 2nd sound splitting
  2. Aortic regurgitation- Third sound
  3. Mitral stenosis- 4th sound
  4. Mitral regurgitation- pericardial rub
30
Q

What are the common systolic/ diastolic murmurs?

A
  1. Systolic
    - Aortic stenosis: ejection systolic
    - Mitral regurgitation: pan systolic
  2. Diastolic
    - Atrial regurgitation: early diastolic
    - Mitral stenosis: mid diastolic

cvs (21 decks)

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