Valvular Heart Disease

Question 1

Mitral Stenosis can be a result of

Answer 1

rheumatic heart disease

congenital MS

Question 2

clinical manifestations of mitral stenosis

Answer 2

dyspnoea

haemoptisis (ruptured walls of veins)

systemic embolism

Chest pain

Question 3

Mitral Stenosis clinical examination

Answer 3

mitral facies

pulse is normal

JVP is a prominent a wave

tapping apex beat and diastolic thrill

RV have

Question 4

Mitral stenosis investigations

Answer 4

ECG

catheterisation

CXR (left atrium enlargement)

echo

Question 5

Mitral stenosis medical treatment

Answer 5

diuretics and restriction of Na intake

control of ventricular rate

anticoagulation

Question 6

Mitral regurgitation aetiology

Answer 6

rheumatic heart disease

mitral valve prolapse (MVP)

degenerative

Question 7

Mitral regurgitation clinical manifestations

Answer 7

SOB

fatigue

right heart failure

dyspnoea

palpitations

Question 8

Mitral regurgitation clinical examination

Answer 8

plus - normal

JVP is prominent

hyper dynamic apex beat

RV heave

reduced S1 sound

Question 9

Mitral regurgitation investigations

Answer 9

ECG

CXR (LA enlarged)

catheterisation

echo

Question 10

mitral regurgitation medical treatment

Answer 10

preload and after loads reduction

Question 11

Aortic stenosis aetiology

Answer 11

degenerative (linked to atherosclerosis)

rheumatic

Question 12

Aortic stenosis symptoms

Answer 12

long asymptomatic phase then…

chest pain

syncope (dizziness)

SOB

heart failure

Question 13

Aortic stenosis clinical examination

Answer 13

pluse

JVP prominent

vigurous apex beat

RV heave

normal S1, less audible S2

Question 14

Aortic stenosis investigations

Answer 14

ECG

CXR

catheterisation

echo

Question 15

Aortic regurgitation aetiology

Answer 15

dilated aorta

connective tissue disorders

leaflets:
bicuspid valve

rheumatic heart disease

Question 16

Aortic regurgitation symptoms

Answer 16

exertion breathlessness

Question 17

aortic regurgitation clinical examination

Answer 17

pulse- large volume and collapsing

wide pulse pressure

hyper dynamic apex beat

normal S1 and normal S2

Question 18

Aortic regurgitation investigations

Answer 18

ECG

CXR

catheterisation

echo

Question 19

Aortic regurgitation treatment

Answer 19

vasodilator therapy

Question 20

in all these cases - interventional treatment at the worst stage would involve complete

Answer 20

valve replacement or repair

Question 21

what is mitral regurgitation?

Answer 21

back flow through the mitral valve during systole

Question 22

Causes of valvular heart disease in the adult

Answer 22

degenerative

congenital

infective

inflammatory

neoplastic

Trauma

Question 23

Rheumatic fever is treated with

Answer 23

Aspirin

Question 24

Rheumatic fever is a result of

Answer 24

Streptococcal infections

Question 25

Endocarditis two main organisms responsible

Answer 25

strep viridans staph aureus

Question 26

indications for surgery in endocarditis

Answer 26

Severe valvular regurgitation Large vegetations Persistent pyrexia Progressive renal failure

Question 27

Aortic regurgitation typically presents as

Answer 27

heart failure or angina

Question 28

aortic regurgitation murmur is easy/difficult to hear

Answer 28

difficult

Question 29

aortic stenosis murmur is easy/difficult to hear

Answer 29

easy

Question 30

aortic stenosis typically presents as

Answer 30

heart failure or angina

Question 31

Mitral stenosis murmur is easy/difficult to hear

Answer 31

difficult

Question 32

mitral regurgitation murmur is easy/difficult to hear

Answer 32

easy

Question 33

Cardiopulmonary bypass involves blood being

Answer 33

drained from the right atrium and returned to the ascending aorta (heart and lung function is taken over by the CBP machine)

Question 34

Max time for a CBP machine is

Answer 34

12 hours

Question 35

mechanical valve will mean the patient is on ........ for life

Answer 35

warfarin