Valvular Heart Disease Flashcards
What are the common symptoms?
- chest pain
- breathlessness
- collapse / dizzy spells
What are the four classes of the new York heart association functional classification?
class I - no limitation class II - slight limitation of ordinary activity class III - marked limitation of less than ordinary activity class IV - severe limitation of minimal activity or at rest
what are the signs of right heart failure?
- raised JVP
- pitting oedema
- hepatic congestion
How do you know if a murmur is systolic or diastolic?
- 1st heart sound - mitral and tricuspid valve closing, start of systole
- 2nd heart sound - aortic and pulmonary valves closing, start of diastole.
what are the types of systolic murmur?
- pansystolic
- ejection systolic
what are the types of diastolic murmur?
- early diastolic
- mid diastolic
where does aortic stenosis normally radiate to?
carotids
where does mitral regurgitation normally radiate to?
axilla
what are the grades of murmurs?
I. Very quiet II. Quiet - easy to hear III. Loud IV. Loud with a thrill V. Very loud with a thrill VI. Loud - audible without a stethoscope
when are right-sided murmurs normally louder?
with inspiration
what is valve stenosis?
when valves do not open properly
what is valve regurgitation?
valves do not close properly
what is mixed valve disease?
valves neither open or close properly.
what are the signs and symptoms of aortic stenosis?
- breathlessness
- chest pain
- dizziness / syncope
- low volume pulse
- forceful displaced apex
- ejection systolic murmur that can radiate to the carotid
what are the treatment options for aortic stenosis?
- conventional valve replacement
- trans catheter aortic valve replacement (TAVI)
- balloon aortic valvotomy (BAV)
what are the differences between mechanical and bio-prosthetic heart valves?
- younger patient more likely to be given mechanical.
- bio-prosthetic require no warfarin.
- bio-prosthetic only last for about 10 years.
What are the causes for mitral regurgitation?
Leaflets: Prolapse ,Rheumatic, Myxomatous (floppy), Endocarditis
Chordae rupture (degenerative) : Prolapse/flail leaflet
Papillary muscles rupture:
Ischaemic
Annular dilatation:
Functional
what are the signs and symptoms of mitral regurgitation?
- breathlessness
- peripheral oedema
- fatigue
- displaced apex
- pansystolic murmur (axilla)
what are the treatment options for mitral regurgitation?
- medication: diuretics and heart failure (ACE inhibitor)
- surgical: repair (prolapse), replacement (degenerative)
- percutaneous (clips in infancy - encouraging results)
what are the signs and symptoms of mitral stenosis?
- breathlessness
- fatigue
- palpitations (AF)
- malar flush
- tapping apex beat
- mid diastolic rumbling diastolic murmur localised to apex
what are the treatment options for mitral stenosis?
- medication: diuretics and treat AF
- surgery: valve replacement
- balloon valvuloplasty
what are the causes of aortic regurgitation?
Leaflets:
- Endocarditis
- Connective tissue diseases
- Rheumatic
Annulus:
- Marfans
- Aortic dissection
what are the signs and symptoms of aortic regurgitation?
- breathlessness
- collapsing pulse
- wide pulse pressure
- displaced apex
- early diastolic murmur left sternal edge
what are the treatment options for aortic regurgitation?
medication - ACE inhibitor
surgery - symptoms and LV dilatation, valve replacement
Causes of aortic stenosis?
R - rheumatic fever
E - Elderly (calcification of mitral (bicuspid) valve)
C- congestive heart disease
