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Systems: Cardiovascular > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

What causes Mitral stenosis?

A
  • Rheumatic Heart Disease
  • Congenital MS
  • Systemic conditions (Lupus-Rheumatic arthritis)
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2
Q

How is stenosed mitral orifice?

A

<2cm3

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3
Q

How big should mitral orifice usually be?

A

4-6cm3

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4
Q

What ultimately happens with mitral stenosis?

A

Right heart dilation with tricuspid regurgitation

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5
Q

What happens to the rest of the body?

A

LV Pressure and systolic function normal

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6
Q

When can mitral stenosis cause tachycardia?

A
  • Exercise
  • Acute
  • Pregnancy
  • Atrial Fibrilation
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7
Q

What can mitral stenosis cause?

A
  • Dysponoea
  • Haemoptisis
  • Systemic embolisation
  • Chest pain
  • Hoarseness
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8
Q

What does mitral stenosis cause haemoptisis?

A

-Rupture of thin walled veins

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9
Q

Why does Mitral Stenosis cause haorseness?

A

-Compression of the L recurrent laryngeal nerve

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10
Q

What can you find on examination with someone with Mitral Stenosis?

A
  • Mitral Facies
  • Pulse=Normal
  • JVP=Prominent a wave
  • Tapping apex beat and diastolic thrill
  • RV heave
  • Auscultation
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11
Q

What do you find on an CXR with some one who has mitral stenosis?

A

LA enlargement

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12
Q

What is the medical treatment of mitral stenosis?

A
  • Diuretics and restriction of NA intake

- Anticoagulants

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13
Q

What is the interventional treatment

A

Valvotomy (balloon vs Surgical)

Mitral valve replacement

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14
Q

What causes mitral regurgtitation?

A
  • Rheumatic heart disease

- Mitral valve prolapse

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15
Q

What causes Functional Mitral regurgitation?

A

Left ventricular annular dilatation

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16
Q

What does ERO mean?

A

effective regurgitant orifices

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17
Q

How does the left ventricle compensate in acute MR?

A

Decreases end systolic pressure and volume

Decreases in wall tension

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18
Q

How does left ventricel compensate in chronic cases of MR?

A

Increases End diastolic volume and End systolic volume returns to normal

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19
Q

What does increaseing EDV do to the left ventricle?

A

makes it eccentric

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20
Q

What happens to the compliance of the LA?

A

Both increased and reduced?

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21
Q

Why is LA compliance reduced?

A

Marked pressure rise causing thickening of atrial myocardium

increase in pulmonary vascular resistance and remodelling of the pulmonary vasculature

22
Q

Why is LA compliance increased?

A

Marked volume enlargement , lesser changes in pulmonary asculature but develop AF

23
Q

What can be seen with acute Mitral regurgitation?

A

Breathlessness
pulm oedema
cardiogenic shock

24
Q

What can be seen with chronic MR?

A 
Fatigue exhausion (low CO) Right heart failure
Dyspnoea or palpitations due to Atrial fibrillation
25
Q

What can cause valve perforation?

A

Infection

26
Q

What is pulse rate like in MR?

A

normal or reduced in heart failure

27
Q

What JVP like in MR?

A

Prominent in RH failure present

28
Q

What is the apex beat like in MR?

A

Brisk and Hyperdynamic

29
Q

What is shown in an ECG with MR?

A

LA enlargement

Prominent R wave in Right precordial leads

30
Q

What can be seen in a CXR of someone with MR?

A

Cardiomegaly, LA enlargement or calcification of mitral mitral annulus

31
Q

What causes MR?

A

Leaflet dysfunction
Chordae
pap muscle
Annular disease

32
Q

What is the medical treatment for mitral stenosis?

A
  • Acute= Preload and afterload reduction may be life saving

- Chronic : not a whole pile mostly for LV function presentation

33
Q

What is the interventional treatment for MR?

A

Mitral valve repair

Mitral valve replacement

34
Q

What can cause aortic stenoisis?

A

Rheumatic and Degenrative conditions

35
Q

How does rhuuematic disease cause aortic stenosis?

A

Adhesion, fusion of the commissures and retraction and stiffening of the free cusp margins

36
Q

How does degenerative disease cause aortic stenosis?

A

Linked atherosclerosis, a slow inflammatory process resulting in thickening and calcification of the cusps from base to free margins

37
Q

What does Aortic stenosis ultimately cause?

A 
concentric hypertrophy 
Left atrial p increases 
Increases 02 demand
Myocardial ischaemia
LV failure
38
Q

What are the cardinal symptoms of aortic stenosis?

A

-Chest pain
_syncope
-Breathlessness on exertion
-Heart failure

39
Q

What does the pulse look like for aortic stenosis?

A

Small volume and slowly rising

40
Q

What does the JVP look like with some who has aortic stenosis?

A

Prominent if RH failure present, low BP

41
Q

What is the apex beat like in Aortic stenosis?

A

Vigurous and sustained

Also RV heave

42
Q

How do you treat aortic stenosis?

A

Aortic vlave replacement

43
Q

What can cause aortic regurgitation?

A

Dilated arota

Or dysfunctional leaflets

44
Q

What causes the aorta itself to cause aortic regurgitation?

A

Dilated aorta

Connective tissue disorders

45
Q

What causes dysfunction in the leaflets which in turn causes aortic regurgitation

A
  • Rheumatic heart disease
  • Endocarditis
  • Myxomatous degeneration
46
Q

What does aortic regurgitation?

A

Increased LV systolic pressure
LV hypertrophy and Lv dilatation
-Myocardial ischaemia

47
Q

What are the symptoms of chronic AR?

A
  • Long asymptomatic phase

- Exertional breathlesness

48
Q

What are the symptoms of Acute AR?

A

Poorly tolerated as wall tension cannot acutely adopt

49
Q

What is pulse rate like with AR?

A

Large volume and collapsing (corrigan sign)

50
Q

What is the apex beat like for someone with AR?

A

Hyperdynamic displaced apex

51
Q

What can be seen on an ECG of someone with AR?

A

ST/T changes

52
Q

What can be seen in CXR for someone with AR?

A

If chronic cardiomegaly

Systems: Cardiovascular (31 decks)

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