Valvular Heart Disease

Question 1

define valvular heart disease

Answer 1

abnormality in one or more of the heart valves

Question 2

define stenosis

Answer 2

insufficient opening of the heart valve

Question 3

define regurgitation

Answer 3

inability of the heart valve to close correctly

Question 4

causes

Answer 4

• congenital e.g. Marfans
• endocarditis
• connective tissue disorder
• rheumatic fever

Question 5

presentation of valvular heart disease

Answer 5

chest pain
syncope
SOB (activity, orthopnoea, paroxysmal nocturnal dyspnoea)
ankle oedema
right sided heart failure (raised JVP, oedema, parasternal heave, cor pulmonale)

Question 6

define cor pulmonale

Answer 6

abnormal enlargement of the right side of the heart

Question 7

diagnosis of valvular heart disease

Answer 7

• echocardiogram
• cardiac catheterisation
• auscultation

Question 8

management of valvular heart disease

Answer 8

• valve replacement (warfarin need for mechanical valves, but not bio-prosthetic)
• if unfit for replacement then balloon valvuloplasty (stenosis) or a transcatheter aortic valve implantation TAVI and BAV

Question 9

aortic stenosis

Answer 9

• low volume pulse
• forceful displaced apex
• ejection systolic murmur radiating to the carotids (crescendo decrescendo murmur)

Question 10

aortic regurgitation

Answer 10

collapsing pulse
wide pulse pressure
displaced apex
early diastolic murmur left sternal edge

Question 11

mitral stenosis

Answer 11

AF
malar flush
tapping apex
mid-diastolic murmur rumbling localised to apex

Question 12

mitral regurgitation

Answer 12

pansystolic murmur radiating to the axilla