Valvular Heart Disease Flashcards
what vasoactive substances are secreted in carcinoid syndrome?
serotonin and kallikiren
what does kallikiren cause?
flushing of the skin
where are carcinoids normally found, and is this a problem?
normally in appendix or ileum, but are asymptomatic because the substances are deactivated by the liver
what is normal area of the tricuspid valve?
7 cm
in tricuspid stenosis, what increased mean diastolic pressure leads to venous congestion?
> 4 mmHg
what kind of murmur would you hear for tricuspid stenosis?
diastolic murmur on inspiration
in what valvular disease would you see elevated RA pressure with a prominent A wave?
tricuspid stenosis
what are three treatment options for tricuspid stenosis?
sodium restriction diet
balloon valvuloplasty
open valve replacement
is tricuspid regurgitation well tolerated?
yes
what kind of murmur would you hear with tricuspid regurgitation?
pansystolic murmur on inspiration
in what valvular disease would you see a prominent V wave on a RA pressure curve?
tricuspid regurgitation
if surgical intervention is needed for tricuspid regurgitation, what two conditions should you think of?
endocarditis or carcinoid
when does pulmonary stenosis often present?
fourth or fifth decade of life
what kind of murmur would you hear with pulmonic stenosis?
SEM in 3rd or 4th intercostal space
what is the most common cause of pulmonic stenosis?
congenital
in pulmonic stenosis, what Doppler pressure gradients are mild, moderate and severe
< 40 mmHg is mild
40-80 mmHg is moderate
> 80 mmHg is severe
what is the preferred treatment for pulmonic stenosis?
mild to moderate needs no treatment
for severe, balloon valvuloplasty is preferred
what kind of murmur would you hear with pulmonic regurgitation?
low pitched murmur in 3rd or 4th intercostal spaces
what is a Graham steel murmur in pulmonic regurgitation?
high pitched diastolic blowing murmur when PAP > 70 mmHg
what is the difference between primary and secondary mitral regurgitation?
primary is if there is a defect with the leaflets
secondary is due to dilation of the heart muscle pulling the leaflets apart
how is chronic mitral regurgitation treated?
vasodilator therapy with ACEs, ARBs or hydralazine
how is pulmonary congestion treated
diuretics
what are two drugs to use in the treatment of mitral regurgitation?
sodium nitroprusside and nitroglycerine
what happens to left ventricular function following a mitral valve replacement?
it worsens, because the low impedance route is eliminated
