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Cardiovascular 2018 > Valvular heart disease > Flashcards

Valvular heart disease Flashcards

1
Q

What are the signs of right heart failure?

A

Raised JVP
Pitting oedema
Hepatic congestion

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2
Q

What happens to the apex beat in mitral stenosis?

A

Tapping apex beat

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3
Q

What happens to the apex bear in left ventricular dilatation?

A

Displaced and diffuse

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4
Q

What happens to the apex beat in left ventricular hypertrophy?

A

Heaving and may be displaced

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5
Q

What does a left parasternal heave indicate?

A

Right ventricular overload

Cor pulmonale/pulmonary hypertension

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6
Q

What is a cardiac murmur?

A

Audible turbulence of blood flow

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7
Q

What is the first heart sound?

A

Mitral and tricuspid valve closing

Start of systole

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8
Q

What is the second heart sound?

A

Aortic and Pulmonary valve closing

Start of diastole

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9
Q

What are diastolic murmurs always?

A

Pathological

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10
Q

What are the types of systolic murmur?

A

Pansystolic

Ejection systolic

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11
Q

What are the types of diastolic murmur?

A

Early diastolic

Mid diastolic

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12
Q

Which murmur radiates to the carotid?

A

Aortic stenosis

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13
Q

Which murmur radiates to the axilla?

A

Mitral regurgitation

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14
Q

Which murmurs are influenced by respiration?

A

Right sided murmurs are louder with inspiration

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15
Q

What are the gradings of murmur severity?

A 
I.	Very quiet
II.	Quiet- easy to hear
III.	Loud
IV.	Loud with a thrill
V.	Very loud with a thrill
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16
Q

Describe an innocent murmur?

A

Soft (less than 3/6)
Position dependant
Often early systolic

17
Q

What are the causes of mitral regurgitation?

A 
Leaflets
>prolapse
>rheumatic
>myxomatous
>endocarditis
Chordae rupture (dengenerative) 
>prolapse, flail leaflet

Papillary muscle rupture
>ischaemia

Annular dilatation
>functional

18
Q

What are the symptoms of mitral regurgitation?

A

Breathlessness
Peripheral oedema
Fatigue

19
Q

What are the signs of mitral regurgitation?

A

Displaced apex

Pansystolic murmur radiating to the axilla

20
Q

What are the treatments for mitral regurgitation?

A

Medication
>diuretics and heart failure (ACE)

Surgical
>repair- prolapse
>replacement- degenerative

Percutaenous
>clips in infancy

21
Q

What are the causes of aortic stenosis?

A

Degenerative
Congenital e.g. bicuspid valve
Rheumatic

22
Q

What are the symptoms of aortic stenosis?

A

Breathlessness
Chest pain
Dizziness/syncope

23
Q

What are the signs of aortic stenosis?

A

Low volume pulse
Forceful displaced apex
ejection systolic murmur radiating to carotids

24
Q

What are the treatment options of aortic stenosis?

A

Conventional valve replacement

Trans-catheter aortic valve replacement (TAVI)

Balloon aortic valvotomy

25
Q

What are the types of valves used in aortic stenosis valve replacement?

A

Mechanical

  • longevity
  • warfarin
  • younger patients

Bio-prosthetic

  • no warfarin
  • 10 years
  • older patients
26
Q

What are the benefits of AVR over TAVI?

A

Long term outcomes, no contra-indications.

TAVI has other co-morbities associated with it

27
Q

What are the causes of aortic regurgitation?

A

Leaflets
>endocarditis
>connective tissue disease
>rheumatic

Annulus
>marfans
>aortic dissection

28
Q

What are the symptoms of aortic regurgitation?

A

Breathlessness

29
Q

What are the signs of aortic regurgitation?

A

Collapsing pulse
Wide pulse pressure
displaced apex
early diastolic murmur left sternal edge

30
Q

What is the treatment for aortic regurgitation?

A

Medication
>ACE inhibitors

Surgery
>symptoms and LV dilatation
>Valve replacement

31
Q

What are the causes of mitral stenosis?

A

Rheumatic

Rarely congenital

32
Q

What are the symptoms of mitral stenosis?

A

Breathlessness
Fatigue
Palpitations AF

33
Q

What are the signs of mitral stenosis?

A

Malar flush
Tapping apex beat
Mid diastolic rumbling localised to apex

34
Q

What are the treatments of mitral stenosis?

A

Medication
-diuretics and treat AF

Surgery
-valve replacement

Balloon valvuloplasty

35
Q

What other heart sounds can be present?

A

continuous murmurs

tricuspid regurgitation

pericardial rub

2nd sound splitting

third sound

fourth sound

systolic clicks

36
Q

Describe valve stenosis?

A

Valves which do not open properly

37
Q

Describe valve regurgitation?

A

Valves which do not close properly

38
Q

Describe mixed valve disease?

A

Valves that neither open or close properly

Cardiovascular 2018 (39 decks)

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