Valvular heart disease

Question 1

Patients with risk factors for development of VHD would be classified at what stage according to AHA/ACC.

Answer 1

stage A

Question 2

Patients with progressive VHD (mild to moderate asymptomatic) would be classified at what stage according to AHA/ACC.

Answer 2

stage b

Question 3

Patients with asymptomatic VHD with compensated left and right ventricel would be classified at what stage according to AHA/ACC.

Answer 3

stage c1

Question 4

Patients with asymptomatic VHD with decompensated left and right ventricle would be classified at what stage according to AHA/ACC.

Answer 4

Stage C2

Question 5

Patients with developed symptoms VHD would be classified at what stage according to AHA/ACC.

Answer 5

Stage D

Question 6

Mitral stenosis would be heard during what diastole or systole; which part of stethoscope is best to use?

Answer 6

diastole, can be heard during s1, as low pitched murmur, mid-diastolic apical crescendo rumble, best heard with bell of stethoscope at apex

Question 7

predominant illness that causes of Mitral Stenosis; What would you hear

Answer 7

females with rheumatic fever, heard during S1 as loud, low pitched murmur, mid-diastolic apical crescendo rumble

Question 8

Mitral regurgitation is heard with what heart sound, during what point of heart action? How does it sound, where is heard best

Answer 8

Mitral regurgitation indicated by S3 heart sound, Mitral regurgitation is best heard during systole, around the 5 ICS at the apex or left axilla, will sound like high pitched musical blowing

Question 9

Aortic Stenosis can be heard during which heart phase of action,: where is it best heard, How does it sound?

Answer 9

Aortic stenosis is best heard during systole, hear around the 2nd ICS (may radiate to neck) with a harsh blowing murmur sound

Question 10

Aortic regurgitation is heard with what heart phase of action? How does it sound, where is heard best

Answer 10

Aortic Regurgitation is heard best during diastole at the 2nd ICS as a blowing murmur

Question 11

Diagnostic testing for MS shows

Answer 11

ECG: p wave >0.12 sec (LAE, Atrial fibrilation, or RVH)
CXR: LAE, RVH, calcifications of mitral valve
TTE: assess etiology
TEE: if TTE inconclusive
Cardiac Cath:

Question 12

Treatment for MS

Answer 12

Diuretics, low salt diet, thromboembolism prevention (class1) for atrial fibrilation

Question 13

Common cause of Left ventricular outflow is

Answer 13

aortic stenosis

Question 14

What are the classic triad of symptoms for aortic stenosis

Answer 14

syncope, angina, Heart failure

Question 15

Aortic stenosis is best heard where and when

Answer 15

Aortic stenosis is best heard during systole at the upper right sternal boarder (may radiate to carotids)

Question 16

Aortic Stenosis testing for diagnosis.

Answer 16

ECG;
CXR: LVH, cardiomegaly, calicifications seen,
TTE: leaflet calcification, and morphology
TEE; for inconclusive TTE
Exercise testing: if symptoms unclear
Dobutabmine stress echo;

Question 17

How is Aortic stenosis treated

Answer 17

surgically

Question 18

Causes of Mitral regurgitation

Answer 18

Primary: Leaflet lesions, rheumatic fever, or other cardiac diseases
Secondary: LVH, dilated cardiomyopathy, Ischemic (MI),

Question 19

Diagnosis of Mitral regurgitation acute and chronic

Answer 19

Acute: pulmonary edema, hypotension from decreased CO, tachycardia,systolic murmur at apex
Chronic: pulmonary congestion, reduced CO,
midsystolic click, apex murmur radiates to axilla, split s2

Question 20

Diagnostic tests for Mitral regurgitatoin

Answer 20

ECG; Left Atrial enlarge, LVH, AF

CXR; enlarged left atrium, cardiomegaly, pulmonary edema

Question 21

Treatment mitral regurgitation

Answer 21

Acute: Reduce afterload with IV nitro, DONOT slow heart rate (patients have compensating tachycardia for adequate CO)
Chronic:
-primary: no treatment
-secondary: ACEI and B-blockers, also cardiac resynchronization therapy for favorable remodel

Question 22

Atrial regurgitation presentation for acute and chronic

Answer 22

Acute: patient may present with symptoms of cardiogenic shock
Chronic: patient may present with symptoms of CHF and angina (due to compensation)

Question 23

Atrial regurgitation diagnostic tests

Answer 23

ECG;
CXR
TTE
TEE
Cardiac cath:
MRI/CT: evaluate for aortic disection

Question 24

Atrial regurgitation treatment

Answer 24

antibiotics for acute endocarditis causes

vasodilator therapy and beta blockers for chronic