Valvular Heart Disease Flashcards
Mitral Stenosis can be a result of
rheumatic heart disease
congenital MS
clinical manifestations of mitral stenosis
dyspnoea
haemoptisis (ruptured walls of veins)
systemic embolism
Chest pain
Mitral Stenosis clinical examination
mitral facies
pulse is normal
JVP is a prominent a wave
tapping apex beat and diastolic thrill
RV have
Mitral stenosis investigations
ECG
catheterisation
CXR (left atrium enlargement)
echo
Mitral stenosis medical treatment
diuretics and restriction of Na intake
control of ventricular rate
anticoagulation
Mitral regurgitation aetiology
rheumatic heart disease
mitral valve prolapse (MVP)
degenerative
Mitral regurgitation clinical manifestations
SOB
fatigue
right heart failure
dyspnoea
palpitations
Mitral regurgitation clinical examination
plus - normal
JVP is prominent
hyper dynamic apex beat
RV heave
reduced S1 sound
Mitral regurgitation investigations
ECG
CXR (LA enlarged)
catheterisation
echo
mitral regurgitation medical treatment
preload and after loads reduction
Aortic stenosis aetiology
degenerative (linked to atherosclerosis)
rheumatic
Aortic stenosis symptoms
long asymptomatic phase then…
chest pain
syncope (dizziness)
SOB
heart failure
Aortic stenosis clinical examination
pluse
JVP prominent
vigurous apex beat
RV heave
normal S1, less audible S2
Aortic stenosis investigations
ECG
CXR
catheterisation
echo
Aortic regurgitation aetiology
dilated aorta
connective tissue disorders
leaflets:
bicuspid valve
rheumatic heart disease
Aortic regurgitation symptoms
exertion breathlessness
aortic regurgitation clinical examination
pulse- large volume and collapsing
wide pulse pressure
hyper dynamic apex beat
normal S1 and normal S2
Aortic regurgitation investigations
ECG
CXR
catheterisation
echo
Aortic regurgitation treatment
vasodilator therapy
in all these cases - interventional treatment at the worst stage would involve complete
valve replacement or repair
what is mitral regurgitation?
back flow through the mitral valve during systole
Causes of valvular heart disease in the adult
degenerative
congenital
infective
inflammatory
neoplastic
Trauma
Rheumatic fever is treated with
Aspirin
Rheumatic fever is a result of
Streptococcal infections
Endocarditis two main organisms responsible
strep viridans
staph aureus
indications for surgery in endocarditis
Severe valvular
regurgitation
Large vegetations
Persistent pyrexia
Progressive renal failure
Aortic regurgitation typically presents as
heart failure or angina
aortic regurgitation murmur is easy/difficult to hear
difficult
aortic stenosis murmur is easy/difficult to hear
easy
aortic stenosis typically presents as
heart failure or angina
Mitral stenosis murmur is easy/difficult to hear
difficult
mitral regurgitation murmur is easy/difficult to hear
easy
Cardiopulmonary bypass involves blood being
drained from the right atrium and returned to the ascending aorta
(heart and lung function is taken over by the CBP machine)
Max time for a CBP machine is
12 hours
mechanical valve will mean the patient is on …….. for life
warfarin
