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Cardiovascular Diseases > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

What types if symptoms are characteristic of valvular heart disease?

A

Exertional symptoms

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2
Q

What is a tapping apex characteristic of?

A

Mitral stenosis

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3
Q

What could a displaced heaving apex be characteristic of?

A
  • Left ventricular dilation (volume overload)
  • LVH (pressure overload)
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4
Q

What does a parasternal heave indicate?

A
  • Right Ventricular overload
    • Cor pulmonale/pulmonary hypertension
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5
Q

What is a cardiac murmur?

A

Audible turbulence of blood flow

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6
Q

What are the six points when describing murmurs?

A
  • Systole or diastole?
  • What type?
  • Where is it loudest?
  • Where does it radiate to?
  • What grade?
  • Influenced by respiration?
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7
Q

What are the sound patterns of:

  1. Aortic stenosis
  2. Mitral regurgitation
  3. Aortic regurgitation
  4. Mitral stenosis
  5. Patent ductus arteriosus
A
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8
Q

What is the difference between ejection systolic and pan systolic?

A
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9
Q

What are the two types of diastolic murmur?

A
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10
Q

What type of murmur radiates to the carotids?

A

Aortic stenosis

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11
Q

What type of murmur radiates to the axilla?

A

Mitral regurgitation

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12
Q

What are the 6 murmur grades?

A
  • I - Very Quiet
  • II - Quiet - easy to hear
  • III - Loud
  • IV - Loud with thrill
  • V - Very loud with thrill
  • VI - Loud - audible without stethoscope
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13
Q

What type of murmurs are louder with inspiration?

A

Right sided

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14
Q

What is an innocent murmur?

A
  • Soft (less than 3/6 severity)
  • Position dependant
  • Often early systolic (diastolic always pathological)
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15
Q

What is mixed valve disease?

A
  • Both stenosis (valve not opening properly) and regurgitation (valve not opening or shutting properly)
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16
Q

What are the three main categories of cause of aortic stenosis?

A
  • Degenerative (age related)
  • Congenital (e.g. bicuspid valve)
  • Rheumatic
17
Q

What are the symptoms and signs of aortic stenosis?

A
  • Breathlessness
  • Chest Pain
  • Presyncope/Syncope
  • Low volume pulse
  • Forceful displaced apex
  • Ejection systolic murmur that can radiate to the carotids
18
Q

What are the treatment options for aortic stenosis?

A
  • Conventional valve replacement
  • TAVI - trans catheter aortic valve replacement
  • BAV - balloon aortic valvotomy
19
Q

What are the two types of prosthetic valves, who gets them and why?

A
  • Mechanical
    • Longevity
    • Warfarin
    • Younger patients
  • Bio-prosthetic
    • No warfarin
    • 10 years
    • Older patients
20
Q

Is AVR or TAVI preferred? Why and when would the less preferred be used?

A
  • AVR
    • Preferred as better long term outcomes
    • No contraindications and can perform CABG also
  • TAVI
    • Co-morbidity
    • Preferred if previous sternotomy
21
Q

What are four causes of leaflet dysfunction in mitral regurgitation?

A
  • Prolapse
  • Rheumatic
  • Myxamatous (floppy)
  • Endocarditis
22
Q

What can cause chordae rupture, papillary muscle rupture and annular dilation leading to mitral regurgitation?

A
  • Chordae rupture - prolapse/flail leaflet
  • Papillary muscle rupture - ischaemic
  • Annular dilatation - functional/congenital
23
Q

What are the symptoms and signs of mitral regurgitation?

A
  • Breathlessness
  • Peripheral oedema
  • Fatigue
  • Displaced apex
  • Pansystolic murmur (radiating to the axilla)
24
Q

What is the treatment of mitral regurgitation?

A
  • Medication
    • Diuretics and HF (ACEI)
  • Surgical
    • Repair - prolapse
    • Replacement - degenerative
  • Percutaneous
    • Clips in infancy
25
Q

What is the main (and rare) cause of mitral stenosis?

A
  • Main - rheumatic
  • Rare - congenital
26
Q

What are the symptoms and signs of mitral stenosis?

A
  • Breathlessness
  • Fatigue
  • Palpitations (AF)
  • Malar flush
  • Tapping apex
  • Mid diastolic rumbling diastolic murmur localised to apex
27
Q

What is the treatment of mitral stenosis?

A
  • Medication
    • Diuretics and treat AF
  • Surgery
    • Valve replacement
  • Balloon valvuloplasty
28
Q

What can damage leaflets and annulus leading to aortic regurgitation?

A
  • Leaflets
    • Endocarditis
    • Connective tissue disease
    • Rheumatic
  • Annulus
    • Marfans
    • Aortic Dissection
29
Q

What are the symptoms and signs of aortic regurgitation?

A
  • Breathlessness
  • Collapsing pulse
  • Wide pulse pressure
  • Displaced apex
  • Early diastolic murmur left sternal edge
30
Q

What is the treatment for aortic regurgitation?

A
  • Medication
    • ACEIs
  • Surgery
    • Valve replacement

Cardiovascular Diseases (9 decks)

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