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CV II Exam 3 > Valvular Heart Disease I > Flashcards

Valvular Heart Disease I Flashcards

1
Q

murmur increases with inspiration

A

right sided

-pulmonary/tricuspid

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2
Q

carvallos sign

A

tricuspid regurg
-gets louder with inspiration

to determined from mitral regurg

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3
Q

a wave

A

atrial contraction

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4
Q

x wave

A

atrial relaxation

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5
Q

v wave

A

atrial filling

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6
Q

y wave

A

atrial emptying

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7
Q

cannon A wave

A

tricuspid stenosis

giant A wave with blunted y descent

pressure against a stenotic tricuspid valve

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8
Q

Tx for tricuspide stenosis

A

diuretics - torsemide and spironolactone (for ascites)

balloon valvotomy, open commissurotomy, bioprosthetic valve (mechanical clots with low flow velocity)

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9
Q

torsemide

A

loop diuretic

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10
Q

kerley B lines

A

on chest Xray

-pulmonary edema from left heart failure

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11
Q

ventricular MI

A

tricuspid valve

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12
Q

ascites, 3/6 systolic blowing murmur at LLSB audible S3, increased with respiration

A

tricuspid regurg

-with prominent cV wave

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13
Q

cV wave

A

tricuspid regurgitation

blood regurgitated no coming back to heart during systole

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14
Q

FenPhen

A

can cause fibrotic changes
-especially to the tricuspid valve

SSRI drugs

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15
Q

Tx of tricuspid regurg

A

treat primary issue - LV failure or pulmonary HTN

true valve defect - bioprosthetic valve - low flow state at tricuspid

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16
Q

bioprosthetic valve

A

used for low flow states

bc mechanical will clot

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17
Q

split P2, diastolic 2/6 murmur at left 2nd ICS, increases with deep breath

A

pulmonic regurg

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18
Q

high pressure vs. low pressure pulmonic regurgitation***

A

high P - prolonged RV systole with split S2, from pulmonary HTN - graham steel

low P - very little murmur, trauma, dilated annulus, carcinoid plaque, bicuspid valve

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19
Q

mitral stenosis backs up to lungs - results in pulmonary insufficiency

A

graham steel murmur

20
Q

most common cause of tricuspid stenosis

A

carcinoid

21
Q

significant valve gradient

A

> 5mmHg - mean right atrial vs. right ventricular pressure

22
Q

Tx high P pulmonic regurg

A

treat pulmonary HTN

23
Q

Tx low P pulmonic regurg

A

watchful expectancy

24
Q

early diastolic sound at mitral area

A

mitral stenosis

loud M1

exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea

25
Q

hockey stick of mitral valve

A

mitral stenosis

26
Q

straight left heart border

A

mitral stenosis

27
Q

negative P wave in V1 and RAD on EKG

A

mitral stenosis

28
Q

thickened immobile leaflets in mitral stenosis

A

rheumatic fever

29
Q

annular calcium deposits in mitral stenosis

A

degenerative

30
Q

moderate mitral stenosis

A

early pulmonary edema

31
Q

severe mitral stenosis

A

pulmonary HTN and right side CHF

32
Q

rumbling diastolic murmur

A

in mitral stenosis

33
Q

valvuloplasty

A

balloon inflated to open stiff valve

34
Q

Tx of mitral stenosis

A

based on ECHO eval scoring

<8 - valvuloplasty
8-10 - mechanical or bioprosthetic valve

35
Q

EKG for mitral regurg

A

left atrial and ventricular enlargement

36
Q

mitral regurg in marfans

A

defective chordae

37
Q

mitral regurg in MI

A

defective papillary muscles

38
Q

mitral regurg in endocarditis

A

defective leaflets

39
Q

mitral regurg in cardiomyopathy

A

defective annulus

40
Q

volume in mitral regurg

A

increased preload
decreased afterload

enlarged LV with increased EF

eventually EF drops when LV fails

41
Q

BNP

A

LV dysfunction

42
Q

hand grip and squatting

A

increased afterload

mitral regurg louder

43
Q

amyl nitrate and valsalva

A

decreased intensity of mitrla regurg

44
Q

EKG for mitral regurg

A

LVH, LAH, or AF

45
Q

sudden onset mitral regurg

A

non-dilated

46
Q

chronic mitral regurg

A

dilated left atria

CV II Exam 3 (21 decks)

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