Valvular Heart Disease

Question 1

What causes aortic stenosis?

Answer 1

Congenital bicuspid vale
Age-related
Rheumatic heart disease

Question 2

What are symptoms of aortic stenosis?

Answer 2

Often initially asymptomatic

Breathlessness, chest pain, dizziness/syncope on exertion

Question 3

What are signs of aortic stenosis?

Answer 3

Slow rising pulse with narrow pulse pressure
Displaced apex beat
Ejection systolic murmur heart in the aortic area radiating to carotids and apex

Question 4

What are investigations for aortic stenosis?

Answer 4

ECG - LVH

Question 5

How is aortic stenosis treated?

Answer 5

Valve replacement surgery
TAVI
Balloon aortic valvotomy

Question 6

What is a TAVI?

Answer 6

Trans-catheter aortic valve replacement

Question 7

What causes mitral regurgitation?

Answer 7

Leaflets (rheumatoid, myxomatous degeneration, endocarditis)
Chordal rupture
Pipillary muscle ischaemia/infarction
Left ventricle enlargement

Question 8

What are symptoms of mitral regurgitation?

Answer 8

Breathlessness

Ankle swelling

Question 9

What are signs of mitral regurgitation?

Answer 9

Displaced and volume overload apex beat; soft S1

Pansystolic murmur maximal at the apex beat and radiating to axilla

Question 10

What would be seen on CXR for mitral regurgitation?

Answer 10

Cardiomegaly

Question 11

How do you treat mitral regurgitation?

Answer 11

Diuretics and ACEI
Surgery
Percutaneous mitral valve reapir, percutaneous clips in infancy

Question 12

What causes mitral stenosis?

Answer 12

Mainly rheumatic

Rarely congenital

Question 13

What are symptoms of mitral stenosis?

Answer 13

Dyspnoea
Fatigue
Palpitations (AF)

Question 14

What are signs of mitral stenosis?

Answer 14

Malar flush
Tapping apex beat
Mid-diastolic murmur localised to apex

Question 15

What are investigations for mitral stenosis?

Answer 15

AF on ECG

CXR - straight heart border

Question 16

How can you treat mitral stenosis?

Answer 16

Diuretics and treat AF
Valve replacement
Balloon valvuloplasty

Question 17

Outline a balloon valvuloplasty?

Answer 17

Blow balloon in calcified mitral valve

Palliative to reduce morbidity and hold-off surgery

Question 18

What causes aortic regurgitation?

Answer 18

Leaflets (infective endocarditis, rheumatic disease)

Annulus (Marfan’s, acute aortic dissection)

Question 19

What are symptoms of aortic regurgitation?

Answer 19

Breathlessness
Chest pain
Dizziness

Question 20

What are signs of aortic regurgitation?

Answer 20

high volume collapsing pulse
Displaced apex
Early diastolic murmur at lower left sternal edge
Wide pulse pressure

Question 21

How is aortic regurgitation treated?

Answer 21

ACEI/ARB, diuretic

Valve replacement

Question 22

Parasternal heave is a sign of?

Answer 22

Left ventricular overload

Question 23

Low volume pulse = ?

Answer 23

Aortic stenosis

Question 24

Collapsing pulse = ?

Answer 24

Aortic regurgitation

Question 25

Tapping Apex beat = ?

Answer 25

Mitral stenosis

Question 26

What type of murmur does aortic stenosis have?

Answer 26

Ejection systolic murmur

Question 27

What type of murmur does mitral regurgitation have?

Answer 27

Pansystolic murmur

Question 28

What kind of murmur does aortic regurgitation have?

Answer 28

Diastolic

Question 29

Diastolic murmurs are _____ pathological

Answer 29

always

Question 30

Right sided murmurs are found with?

Answer 30

Inspiration

Question 31

Valve stenosis =

Answer 31

Valves that don't open properly

Question 32

Valve regurgitation =

Answer 32

Valves that don't close properly