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Year 1 Cardiology > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

Clinical History of Valvular heart disease

A

Cardiac chest pain, breathlessness, collapse, dizzy spells Exertional symptoms

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2
Q

What particular type of breathlessness is related to valvular heart disease

A

Orthopnea- breathless lying down Paroxysmal Nocturnal dyspnoea- waking up SOB

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3
Q

What is a useful question to ask about when gauging the level of SOB

A

How many pillows do you use? More pillows the worse orthopnea

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4
Q

Right sided heart failure

A

raised JVP, pitting oedema, hepatic congestion

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5
Q

Parasternal Heave

A

left of sternum placed vertically right ventricular overload

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6
Q

Causes of parasternal heave

A

Cor pulmonale, pulmonary hypertension

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7
Q

Six questions for assessing an murmur

A

Systole or Diastole What type? Where is it located? Where does it radiate too? What grade is it? Is it influenced by inspiration?

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8
Q

How does the grading for murmurs work?

A

Grade 1- very quiet Grade 6- audible without a stethoscope Grade 4+ - murmur accompanied by a thrill

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9
Q

Which murmur is affected by respiration?

A

Right sided murmurs are louder on inspiration

Left sided murmurs are louder on expiration

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10
Q

What causes a constant murmur?

A

A patent ductus arteriosus

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11
Q

Describe an innocent murmur?

A

Soft less than a 3 Very localised with no radiation

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12
Q

Symptoms of Aortic stenosis

A

Breathless

Increased fatigue

Chest pain

Dizziness

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13
Q

Signs of aortic stenosis

A

Low volume pulse

Forceful displaced apex

High pressure gradient between ventricle and aorta

My show large ST complex due to hypertrophy V1-V6

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14
Q

Murmur of aortic stenosis

A

Ejection systolic murmur

Rdaiates to the carotids

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15
Q

Treatment for aortic stenosis

A

Valve replacement

Trans catheter aortic valve replacment

baloon aortic valvotomy

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16
Q

Benefits of mechanical valve replacement in aortic stenosis

A

Infinite lifespan

Often in younger patients

17
Q

Benefits of bio prosthetic valve replacement in aortic stenosis

A

No warfirin required

Better for older patients

18
Q

Causes of mitral regurgitation

A

Prolapse, Rheumatic, Myxomatous (floppy), endocarditis

19
Q

Name a degenerative cause of mitral regurgitation

A

Chordae rupture

20
Q

Name an ischaemic cause of mitral regurgitation

A

Papilliary muscle rupture

21
Q

Symptoms of mitral regurgitation

A

Breathlessness

Peripheral oedema

Fatigue

22
Q

Signs of mitral regurgitation

A

Displaced apex

Pansystolic murmur

23
Q

What medication would you give for mitral regurgitaion

A

Diuretics and ARB and ACE inhibitors

24
Q

Surgical options for mitral regurgitation

A

Prolapse- Repair

Degeneration- Replacement

Infancy- percutaneous clip attatchment

25
Q

Mitral Stenosis

A

Main cause is essentially rheumatic

Congenital is rare

26
Q

Symptoms of mitral stenosis

A

Atrial fibrillation- atria dilates as pressure builds up as increased volume stored in atria

SOB

Fatigue

27
Q

Symptoms of mitral stenosis

A

Mallar flush- plum red cheeks due to CO2 retention

Tapping apex beat

28
Q

Murmur associated with mitral stenosis

A

Mid diastolic rumbling murmur localised to the apex beat

29
Q

Medication for mitral stenosis

A

Treat the atrial fibrilation - anticoagulants, Beta blockers Ca2+ channel blockers

Diuretics

30
Q

Aortic regurgitation causes

A

Endocarditi,connective tissue diseases, rheumatic, marfans, aortic dissection

31
Q

Signs or aortic regurgitation

A

Collapsing pulse

Wide pulse pressure

Displaced Apex

32
Q

Murmur associated with aortic regurgitation

A

Early diastolic murmur

Located at left sternal edge

33
Q

Treatment for Prosthetic valve infection

A

Gentamicin+ Vancomycin IV

Add rifiampacin 3-5 days later

Often valve replacement

34
Q

Treatment for native valve endocarditis

A

Amoxycillin + gentamicin IV

Usually Viridans Streptococci

35
Q

Treatmant for drug user endocarditis

A

Flucloxacillin IV

36
Q

Subacute Presentation of infective endocarditis

A

Clubbing

Splinter haemorrhage

New Murmur

Fever

Fatigue

Roth spots

Year 1 Cardiology (17 decks)

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