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LC Cardiology Week 6 > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

What type of symptoms are characteristic of valvular heart disease?

A

Exertional symptoms

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2
Q

Describe the New York heart association functional classification

A

Class I - No limitation
Class II - Slight limitation of ordinary activity
Class III - Marked limitation of less than ordinary activity
Class IV - Severe limitation of minimal activity or at rest

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3
Q

What are some signs of RHF?

A

Raised JVP
Pitting oedema
Hepatic congestion

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4
Q

Describe the apex beat in mitral stenosis?

A

Tapping apex beat

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5
Q

Describe the apex beat in left ventricular dilation (volume overload)?

A

Displaced and diffuse

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6
Q

Describe the apex beat in left ventricular hypertrophy (pressure overload)?

A

Heaving and might be displaced

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7
Q

Describe where you might feel a parasternal heave and what condition might predispose it?

A

Hand left of the sternum

Right ventricular overload - cor pulmonate/pulmonary hypertension

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8
Q

Describe all 4 auscultation areas?

A

Aortic valve - 2nd intercostal right sternal edge
Pulmonary valve - 2nd intercostal left sternal edge
Tricuspid valve - left sternal border 4th intercostal
Mitral valve - 5th intercostal mid clavicular

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9
Q

What types of systolic murmurs do you get?

A

Pan-systolic

Ejection systolic

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10
Q

What type of diastolic murmurs do you get?

A

Early diastolic

Mid diastolic

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11
Q

What murmur radiates to the carotids?

A

Aortic stenosis

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12
Q

What murmur radiates to the axilla?

A

Mitral regurgitation

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13
Q

Roughly describe the grading of murmurs?

A

1-6
1-3 = can hear, no thrills
3-6 = can hear with thrills

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14
Q

Are right of left sided murmurs louder with inspiration?

A

Right sided murmurs are louder with inspiration

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15
Q

Describe valve stenosis?

A

Valve doesn’t open properly

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16
Q

Describe valve regurgitation?

A

Valve doesn’t close properly

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17
Q

Describe bicuspid valve in aortic stenosis?

A

Congenital condition

When you are born 2 of the aortic valve cusps, fuse together, leaving you with only 2 cusps and not 3.

18
Q

What are some of the causes of aortic stenosis?

A

Degenerative - age related
Bicuspid valve - congenital
Rheumatic

19
Q

What are some of the symptoms of aortic stenosis?

A

Breathlessness
Chest pain
Dizziness

(due to the obstruction in the left ventricle stroke volume caused by aortic stenosis)

20
Q

What are some of the signs of aortic stenosis?

A 
Pulse - low volume, slow rising
Apex - heaving, not displaced 
Ejection click 
S4
LV heave
21
Q

What type of murmur is aortic stenosis?

A

Ejection systolic radiates to the carotids

22
Q

What are the treatment options for aortic stenosis?

A

Conventional valve replacement
TAVI (trans catheter aortic valve replacement)
BAV (balloon aortic valvotomy)

23
Q

What is aortic stenosis?

A

Narrowing of the aortic valve

24
Q

What is mitral regurgitation?

A

A leakage of blood backward through the mortal valve each time the left ventricle contracts

25
Q

What are some causes of mitral regurgitation?

A 
Chordae rupture (degenerative)
Leaflets - myxomatous (floppy), endocardites, rheumatic
26
Q

What are some symptoms of mitral regurgitation?

A

Breathlessness
Peripheral oedema - due to back pressure in the pulmonary venous system
Fatigue - not as much blood not getting pumped out of LV

27
Q

What are some signs of mitral regurgitation?

A

Displaced apex
Pulse - sinus rhythm or AF
(Soft S1 split S2)

28
Q

What type of murmur is mitral regurgitation?

A

Pan systolic murmur at the apex - radiates to the axilla

29
Q

What are the treatment options for mitral regurgitation?

A

Medication - diuretics and heart failure (ACE inhibitors)

Surgical - repair or replacements

30
Q

What is mitral stenosis?

A

Narrowing of the mitral valve.

(Inflammation leads to commissural fusions and a reduction in mortal valve orifice area leading to the characteristics coming pattern seen on ECG)

31
Q

What are the causes of mitral stenosis?

A

Usually rheumatic
(endocarditis)
Congenital is rare

32
Q

What are the symptoms of mitral stenosis?

A

Breathlessness
Fatigue
Palpitations (AF)

33
Q

What are the signs of mitral stenosis?

A

Mallar flush - due to decreased CO
Tapping apex beat
low volume pulse

34
Q

What type of murmur is mitral stenosis?

A

Mid diastolic rumbling murmur localised at the apex

35
Q

What is the treatment for mitral stenosis?

A

Diuretics - decreased preload and pulmonary venous congestion
Treat AF
Surgery - valve replacement
Balloon valvuloplasty

36
Q

What is aortic regurgitation?

A

A leakage of the aortic valve each time the left ventricle relaxes

37
Q

What causes aortic regurgitation?

A

Leaflets - Connective tissue diseases , infective endocarditis
Annulus - Marfans syndrome

38
Q

What are the symptoms of aortic regurgitation?

A

Breathlessness

39
Q

What are the signs of aortic regurgitation?

A

Collapsing pulse

Displaced apex

40
Q

What type of murmur is aortic regurgitation?

A

high pitched early diastolic murmur heard best at the left sternal edge when the patient is sitting forward

41
Q

What treatment options are there for aortic regurgitation?

A

Medication - ACEi

Surgery - if worsening (LV dilatation + symptoms) valve replacement

LC Cardiology Week 6 (3 decks)

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