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Y1 Cardiovascular > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

what is chest pain in valvular disease like?

A

heavy, squeezing and crushing

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2
Q

what is breathlessness in valvular disease usually related to?

A

increased activity

may come on at rest in very severe cases

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3
Q

what is a common side effect of stenosed vessels?

A

collapse

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4
Q

what non-invasive investigation can be done for valvular disease?

A

ECHO

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5
Q

what invasive investigation can be done for valvular disease?

A

cardiac catheterisation

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6
Q

what classification is used to express how much someones breathlessness due to cardiac disease affects their lives?

A

the new york heart association functional classification

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7
Q

name three signs of right heart failure

A

raised JVP
pitting oedema
hepatic congestion

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8
Q

what does a raised JVP suggest?

A

fluid overload associated with heart failure

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9
Q

what two locations may pitting oedema be found in?

A

ankles

sacrum

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10
Q

where is the apex beat normally found?

A

in the 5th ICS, midclavicular line

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11
Q

what happens to the apex beat in mitral stenosis?

A

it creates a tapping beat

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12
Q

what causes a displaced and diffuse apex beat?

A

LV dilation due to volume overload

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13
Q

what causes a heaving and displaced apex beat?

A

LV hypertrophy due to pressure overload

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14
Q

where is the hand placed to feel for a parasternal heave?

A

left of the sternum

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15
Q

what does the presence of a parasternal heave suggest?

A

RV overload

may be due to cor pulmonale, pulmonary hypertension or a congenital heart disease

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16
Q

what is a cardiac murmur?

A

the audible turbulence of blood flow

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17
Q

what causes the first heart sound?

A

closure of the mitral and tricuspid valves

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18
Q

what does S1 mark?

A

the start of systole

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19
Q

what are two systolic murmurs?

A

aortic stenosis

mitral regurgitation

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20
Q

what causes the second heart sound?

A

the closure of the aortic and pulmonary valves

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21
Q

what does S2 start?

A

the end of systole

the start of diastole

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22
Q

what are two diastolic murmurs?

A

aortic regurgitation

mitral stenosis

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23
Q

what two types of systolic murmurs are there?

A

pansystolic

ejection systolic

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24
Q

what is a pansystolic murmur?

A

one loud, continuous sound

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25
Q

what is an ejection systolic murmur?

A

one that gets louder and the quieter again

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26
Q

what two types of diastolic murmurs are there?

A

early diastolic

mid diastolic

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27
Q

where does the murmur from aortic stenosis radiate to?

A

carotids

28
Q

where does the murmur from mitral regurgitation radiate to?

A

the axilla

29
Q

what are the grades for murmurs and what does each mean?

A 
1 = very quiet 
2 = quiet but easy to hear 
3 = loud
4 = loud with a thrill 
5 = very loud with a thrill 
6 = audible without a stethoscope
30
Q

which sided murmurs are louder with inspiration?

A

right sided (mitral)

31
Q

which sided murmurs are louder with expiration?

A

left sided (aortic)

32
Q

who is an innocent murmur common in?

A

young, thin patients

33
Q

describe an innocent murmur

A

soft (less than 3/6)

early systolic

34
Q

what type of murmur is always pathological?

A

diastolic

35
Q

what is stenosis of valves?

A

when valves do not open properly

36
Q

what valve regurgitation?

A

when valves do not close properly

37
Q

what occurs in mixed valve disease?

A

valves that do not open or close properly

38
Q

name three causes of aortic stenosis

A

degenerative
congenital bicuspid aortic valve
rheumatic fever

39
Q

what is a bicuspid aortic valve?

A

when the valve has two cusps instead of three

40
Q

what causes symptoms in aortic stenosis?

A

not enough blood getting round the body

41
Q

name three symptoms of aortic stenosis

A

breathlessness
chest pain
syncope

42
Q

describe the murmur associated with aortic stenosis

A

ejection systolic murmur that can radiate to the carotids

43
Q

name two signs associated with aortic stenosis

A

low volume pulse

forceful displaced apex

44
Q

name three possible treatments for aortic stenosis

A

valve replacement (most common)
TAVI
balloon aortic valvotomy (BAV)

45
Q

what is a TAVI?

A

trans catheter aortic valve replacement

46
Q

what are the two types of prosthetic valve?

A

mechanical

bio-prosthetic

47
Q

which type of prosthetic valve needs to be changed every 10 years?

A

bio-prosthetic

48
Q

which type of valve will result in life long warfarin treatment for the patient?

A

mechanical

49
Q

what is AVR?

A

aortic valve replacement

50
Q

name four causes of mitral regurgitation

A

problems with valve leaflets
chordae rupture
papillary muscle rupture
annular dilation

51
Q

what can cause problems with leaflets that can lead to mitral regurgitation?

A

prolapse
rheumatic fever
endocarditis

52
Q

what may cause chordae rupture?

A

ischaemia

degeneration

53
Q

name three symptoms of mitral regurgitation

A

breathlessness
peripheral oedema
fatigue

54
Q

describe the murmur associated with mitral regurgitation

A

pansystolic murmur that radiates to the axilla

55
Q

name three things involved in treatment of mitral regurgitation

A

diuretics + ACEI
surgical repair
surgical replacement

56
Q

what treatment is done if mitral regurgitation occurs in infancy?

A

clips

57
Q

what is the main cause of mitral stenosis?

A

rheumatic fever

58
Q

name three symptoms of mitral stenosis

A

breathlessness
fatigue
palpitations (AF)

59
Q

name two signs associated with mitral stenosis

A

malar flush

tapping apex beat

60
Q

describe the murmur associated with mitral stenosis

A

mid diastolic rumbling murmur localised to the apex

61
Q

what three things can be done to treat mitral stenosis

A

diuretics
valve replacement
balloon valvuloplasty

62
Q

name a symptom of aortic regurgitation

A

breathlessness

63
Q

name three signs of aortic regurgitation

A

collapsing pulse
wide pulse pressure
displaced apex

64
Q

describe the murmur associated with aortic regurgitation

A

early diastolic murmur at the left sternal edge

65
Q

outline treatment for aortic regurgitation

A

ACEI

valve replacement

Y1 Cardiovascular (22 decks)

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