Valvular Heart Disease I Flashcards
murmur increases with inspiration
right sided
-pulmonary/tricuspid
carvallos sign
tricuspid regurg
-gets louder with inspiration
to determined from mitral regurg
a wave
atrial contraction
x wave
atrial relaxation
v wave
atrial filling
y wave
atrial emptying
cannon A wave
tricuspid stenosis
giant A wave with blunted y descent
pressure against a stenotic tricuspid valve
Tx for tricuspide stenosis
diuretics - torsemide and spironolactone (for ascites)
balloon valvotomy, open commissurotomy, bioprosthetic valve (mechanical clots with low flow velocity)
torsemide
loop diuretic
kerley B lines
on chest Xray
-pulmonary edema from left heart failure
ventricular MI
tricuspid valve
ascites, 3/6 systolic blowing murmur at LLSB audible S3, increased with respiration
tricuspid regurg
-with prominent cV wave
cV wave
tricuspid regurgitation
blood regurgitated no coming back to heart during systole
FenPhen
can cause fibrotic changes
-especially to the tricuspid valve
SSRI drugs
Tx of tricuspid regurg
treat primary issue - LV failure or pulmonary HTN
true valve defect - bioprosthetic valve - low flow state at tricuspid
bioprosthetic valve
used for low flow states
bc mechanical will clot
split P2, diastolic 2/6 murmur at left 2nd ICS, increases with deep breath
pulmonic regurg
high pressure vs. low pressure pulmonic regurgitation***
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
mitral stenosis backs up to lungs - results in pulmonary insufficiency
graham steel murmur
most common cause of tricuspid stenosis
carcinoid
significant valve gradient
> 5mmHg - mean right atrial vs. right ventricular pressure
Tx high P pulmonic regurg
treat pulmonary HTN
Tx low P pulmonic regurg
watchful expectancy
early diastolic sound at mitral area
mitral stenosis
loud M1
exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea
