Valvular Heart Disease Flashcards
What are some of the CAUSES of MITRAL STENOSIS?
1) Rheumatic Fever
2) Congenital Defect
3) Systemic Conditions, i.e. Systemic Lupus Erythematosus and Rheumatoid Arthritis
What are some of the SYMPTOMS of Mitral Stenosis?
1) Mild, Exertional Dyspnoea
2) Haemoptysis
3) Chest Pain
4) Dysphonia (Hoarseness)
5) Systemic Embolisation
6) Infective Endocarditis (IE)
What are some of the SIGNS of Mitral Stenosis?
1) Rumbling Mid-Diastolic Murmur (Heard on Expiration at Apex, with Bell; Patient on Left) 2) Malar Flush 3) Tapping Apex Beat 4) Diastolic Thrill 5) RV Heave
What are the COMMONEST heart VALVE PROBLEMS?
1) Mitral and Aortic Valve Calcification
2) Mitral Valve Prolapse (MVP)
3) Bicuspid Aortic Valve
4) Aortic Sclerosis (Senile Degeneration)
What INVESTIGATIONS would be used to DIAGNOSE VALVULAR DISEASE?
1) ECG
2) CXR
3) Cardiac Catheterisation
4) Echocardiography
5) Cardiac MRI
What are the PHARMACOLOGICAL TREATMENTS for Mitral Stenosis?
1) Diuretics and < Na+ Intake
2) Beta-Blocker OR CCB (i.e. Verapamil or Diltiazem) - For Rate-Control
3) Anticoagulation - Particularly in AF
What are the INTERVENTIONAL TREATMENTS for Mitral Stenosis?
1) Balloon Valvotomy
2) Valve Replacement
*Preserve Native Tissue for as Long as Practically Possible
What are some of the CAUSES of MITRAL REGURGITATION (MR)?
1) Rheumatic Fever
2) MVP
3) IE
4) Annular Calcification
5) LV and Annular Dilatation (Functional MR)
5) Connective Tissue Disorders, i.e. Marfan’s
7) Ruptured Chordae Tendinae
8) Ruptured or Dysfunctional Papillary Muscle
What are some of the SYMPTOMS of MR?
1) Dyspnoea (Due to Pulmonary Oedema or Cardiogenic Shock)
2) Fatigue
3) Palpitations (Due to AF)
What are some of the SIGNS of MR?
1) Pansystolic Murmur (Heard at Apex and Axilla)
2) Dysplaced, Hyperdynamic Apex Beat
3) RV Heave
4) Distended JVP (If HF)
What would be the POSSIBLE FINDING(S) on CXR for Mitral Stenosis?
1) LA Enlargement
2) Pulmonary Oedema
3) Mitral Valve Calcification
What would be the POSSIBLE FINDING(S) on CXR for MR?
1) Cardiomegaly (LA and LV Enlargement)
2) Pulmonary Oedema
3) Mitral Valve Calcification
What would be the POSSIBLE FINDING(S) on Echo for MR?
1) Perforation of Mitral Valve Cusp
2) Annular Disease
3) Chordae Tendinae Rupture/Dysfunction
4) Papillary Muscle Rupture/Dysfunction
5) Systolic Blood Flow Reversal in Pulmonary Veins
What are the PHARMACOLOGICAL TREATMENTS for MR?
1) Diuretics
2) Rate Control (If AF)
3) Anticoagulate (If AF)
What are the INTERVENTIONAL TREATMENTS for MR?
Valvular Replacement or Repair
*Repair, Where Possible, Better than Replacement
What are the CAUSES of AORTIC STENOSIS (AS)?
1) Degeneration/Calcification with Age
2) Rheumatic Disease
3) Congenital Defect - Bicuspid Valve
What are the SYMPTOMS of AS?
Long Asymptomatic Period
Can be:
1) Chest Pain (Tightness/Pressure)
2) Dizziness
3) Syncope
4) Exertional Dyspnoea
5) Heart Failure
What are some of the SIGNS of AS?
1) Ejection Systolic Murmur (Aortic Area; Radiates to Carotids)
2) < Volume and Slow Rising Pulse
3) Distended JVP (If HF or Hypotensive)
4) RV Heave
5) Aortic Thrill
6) Vigorous and Sustained Apex Beat
What would be the POSSIBLE FINDING(S) on CXR for AS?
Calcified Aortic Valve
What would be the POSSIBLE FINDING(S) on Echo for AS?
Left Ventricular Hypertrophy (LVH)
What would be the POSSIBLE FINDING(S) on ECG for AS?
LVH with Strain Pattern
What are the TREATMENTS for AS?
Valvular Replacement or Repair
What are the CAUSES of AORTIC REGURGITATION (AR)?
1) Dilated Aorta (Due to Marfan’s or HTN)
2) Connective Tissue Disorders
3) Congenital Defect (Bicuspid Aortic Valve)
4) Rheumatic Fever
5) IE
6) Myxomatous Degeneration
7) Trauma
What are the SYMPTOMS of AR?
Long Asymptomatic Period
Can be:
1) Exertional Dyspnoea
2) Orthopnoea
3) Paroxysmal Nocturnal Dyspnoea
What are some of the SIGNS of AR?
1) Early, Soft Diastolic Murmur
2) > Volume and Collapsing Pulse
3) Wide Pulse Pressure
4) Hyperdynamic, Displaced Apex Beat
What would be the POSSIBLE FINDING(S) on ECG for AR?
1) LVH
2) Ascending Aorta Dilatation
What would be the POSSIBLE FINDING(S) on CXR for AR?
Cardiomegaly
What would be the POSSIBLE FINDING(S) on Echo for AR?
1) AV Cusp Deficiences (Due to Thickening or Prolapse or Vegetations)
2) LVH or Dilatation
What are the PHARMACOLOGICAL TREATMENTS for AR?
Vasodilator Therapy (i.e. ACEIs)
What are the INTERVENTIONAL TREATMENTS for AR?
Valvular Replacement or Repair
What are the ADVANTAGES and DISADVANTAGES of using a BIOLOGICAL heart valve PROSTHESIS?
Advantage - No Anticoagulation (Warfarin) Required
Disadvantage - Becomes Inviable After 15 Years
What are the ADVANTAGES and DISADVANTAGES of using a MECHANICAL heart valve PROSTHESIS?
Advantage - Valve Lasts for > 40 Years
Disadvantage - Lifetime Anticoagulation is Required
