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CPR2 Exam 1 > Valvular Heart Disease + Murmurs - Dr. Johnston > Flashcards

Valvular Heart Disease + Murmurs - Dr. Johnston Flashcards

1
Q

ventricular HD most common reasons

A
  1. Myxomatous degeneration (MVP)

2. Congenital (Bicuspid Aortic Valve)

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2
Q

Stenosis and Regurgitation does what to the heart

A

S : Pressure overload, hypertrophy and HF

R : Volume overload , dilation and arrhythmia

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3
Q

6 causes of Systolic murmur

A
  1. Aortic stenosis
  2. Pulmonary stenosis
  3. Mitral regurg
  4. Tricuspid regurg
  5. VSD
  6. ASD
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4
Q

5 causes of diastolic murmur

A
  1. Aortic regurg
  2. Pulmonary regurg
  3. Mitral stenosis
  4. Tricuspid stenosis
  5. Atrial Myxoma
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5
Q

murmur grading scale

A

1-6
1 : barely
2. Faint
3. easy to hear
4. loud + palpable thrill
5. heard with stethoscope barley touching + thrill
6. can hear without stethoscope + palpable thrill

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6
Q

4 causes of ACUTE mitral regurgitation

A
  1. Ischemic papillary muscle prob (MI, CAD)
  2. chordal tendineae rupture
  3. Infective endocarditis
  4. Volume overload, high LA P, edema, cadiogenic shock
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7
Q

4 causes of CHRONIC mitral regurgitation

A
  1. Mitral valve prolapse

2. Myxomatous / degenerative valve / mitral annular calcification

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8
Q

Mitral regurgitation ascultation

A

= blowing at apex
= radiates to left axilla
= low S1
= use diaphragm

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9
Q

Mitral Valve Prolapse ascultation

A

= at apex

= click or murmur increases with Valsalva + standing

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10
Q

tx for mitral prolapse

A

reassure , if sx give BB

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11
Q

Tricuspid regurgitation auscultation

A

= blowing left 4th ICS

= increase with inspiration (Carvallo sign)

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12
Q

Tricuspid regurgitation PE ,

A

prominent V wave in elevated JVP, other then that usually asymptomatic

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13
Q

reasons for TR

A

= pulmonary htn, disease,
= RV MI
= inferior wall MI
= Pacemaker

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14
Q

Aortic Stenosis triad sx

A
  1. SOB
  2. Angina
  3. Syncope
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15
Q

Aortic Stenosis ascultation

A

= crescendo –> decreasendo
= harsh right 2nd ICS
= radiates to sternal notch and carotids

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16
Q

Aortic Stenosis PE

A

weak pulse, and slow (parvus and tardus)

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17
Q

Aortic Stenosis EKG

A

downsloping ST segment

18
Q

Aortic Stenosis associations 3

A

Aortic aneurysm
Marfans
Turners

19
Q

Pulmonary Stenosis ascultation

A

= crescendo –> decrescendo left ICS

= radiated to left shoulder and clavicle

20
Q

Pulmonary Stenosis associated with what

A

Tetralogy of Fallot

= Pulmonary Stenosis is usually congenital

21
Q

Ventricular Septal Defect Auscultation

A

= Holosystolic murmur LOWER LEFT sternal border
= thrill
= increase with hand gripping (left to right shunt)

22
Q

Atrial Septal Defect auscultation

A

= UPPER LEFT sternal border murmur
= splitting of S2
= left to right shunt

23
Q

4 causes of Mitral stenosis

A
  1. Rheumatic Heart Disease
  2. Strep Group A
  3. congenital
  4. MAC (Mitral annular calcification)
24
Q

Mitral stenosis can cause

A

Pulmonary htn, A fib, right V failure

25
Q

Mitral stenosis auscultation

A

= low pitch BELL
= rumbling at apex
= Increase S1 and S2 + then opening snap

26
Q

Mitral stenosis sx

A

= SOB
= palpitations (A fib)
= hoarseness, compression of left laryngeal N (Ortners Syndrome)

27
Q

Tricuspid Stenosis auscultation

A

= Left

= increase with inspiration (carvallo sign)

28
Q

Tricuspid stenosis PE

A

A wave prominent in JVP

29
Q

TS associated with

A

= Rheumatic disease (MS)

= female

30
Q

Aortic Regurgitation acute 3 causes

A
  1. infective endocarditis
  2. aortic dissection
  3. chest trauma
31
Q

Aortic Regurgitation (insufficiency) chronic 4 causes

A
  1. calcification degenerative
  2. Bicuspid valve
  3. dilated Aortic root
  4. Rheumatic heart
32
Q

Aortic Regurgitation causes what

A

volume overload, left HF

33
Q

Aortic Regurgitation acute and chronic SX

A

ACUTE : pulmonary Edema

CHRONIC : dyspnea, orthopnea, angina

34
Q

Aortic Regurgitation auscultation

A

= decrescendo 3rd ICS LEFT sternal base (diastole) (Austin Flint)
= can sound like Mitral stenosis
= soft S2

35
Q

Aortic Regurgitation : DeMusset sign

A

head bob with beats

36
Q

Aortic Regurgitation Quincke’s sign

A

capillary nail pulsations

37
Q

Aortic Regurgitation : Traube sign

A

“pistole shot”

= systole and diastole sounds over Femoral A

38
Q

Aortic Regurgitation : Duroziez sign

A

= diastolic murmur over Femoral A when compressed with (BELL)

39
Q

Aortic Regurgitation tx

A

reduce afterload = ACE Inhibitor, ARB

40
Q

Pulmonary Regurgitation (insuffiency) auscultation and associations

A

= decrescendo 2nd ICS LEFT Sternal base (Graham steele) + increased S2 (diastole)
= associated with pulmonary htn

CPR2 Exam 1 (19 decks)

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