Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardio > Valvulopatii > Flashcards

Valvulopatii Flashcards

1
Q

Regurgitare tricuspida

A

Secundar dilatarii inelului din HTP, boli ale cavitatilor stangi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Regurgitre pulm

A

Dilatare inel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Stenoza pulmonara

A

Congenital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Stenoza tricuspida

A

Reumatism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Fiziopatologie valvulopatii la modu general

A 
Solicitare fe presiune sau de volum
Compensare
Dupa vs e cam depasit
Disf miocardica
Insuf cardiaca
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Valvulopatii evaluare genrral

A

Clinic

Ecografic!!! Tt, te, 3d(vad morfologia, mecanism, severitate, impact asupra cavitati si bernouli=>pres in artera pulm)

Test de efort(nu la stenoza aortica)
Stres ecografic cu dobutamina
Ct si angioct pt a face SCOR DE CALCIU, evaluare coronare, evaluare aorta pt TAVI
Coronarografie si cateterism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Regurgitare mitrala etiologie

A
  1. Foite valvulare(raa-deformare, fibroza,retractii, prolaps, endocardita)
  2. Inel (dilatare, calcificare cu imobilizare baza)
  3. Cordaje(ruptura, prolaps-elongare si ruptura, endocardita, solicitare mecanica)
  4. Muschi papilari(posteromediali) ischemie, cicatrici, deplasari prin dilatare vs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Regurgitare mitrala primara secundara cine e srcundara

A

Orice dilatare a vs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Regurgitare mitrala fiziopat

A

Sange se intoarce in as=> crestere pres si vol in as=> crestere pres in pap=>
IN ACUT ptc as nu are timp sa se dilate=> epa si dispnee
IN CRONIC=> congestie

Debit cardiac scazut( mrg initial ptc v diastolic e crescut e mentinut debitul)-asta e trecuta la cronic

E O SOLICITARE DE VOLUM A VS CA INTRA AMBELE VOLUME, logic=»»>IN TIMP DILATARE VS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Severitatea rm(raport dintre volum anterograd si retrograd)

A 
Dimensiune orificiu regurgitare
Gradient presiune(e accentuata de hta)
Complianta as
DURATA REGURGITARII FATA DE SISTOLA(gen la prolaps de obicei e telesistolica regurgitarea)
REZISTENTA VASCULARA SISTEMICA

Fe supranormala(postsarcina«

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Aspect clinic regurgitare mitrala

A

Acut: epa
Cronic: astenie, fatigabilitate
Dispnee-apare fie ptc creste presiunea in as deci e umplere la presiuni mari FIE PTC AVEM DISF VS(se si hipertrofiaza putin ca tre sa intre legea laplace si trb sa scada tens)

Insuf cardiaca dreapta(ptc cresterea de presiune din venele pulmonare se transmite pana la artere si o sa apara ic dreapta): jugulare, hepatomeg, edeme, ascita;;;; apare la o rm veche si severa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Aspect clinic rm

A

Suflu sistolic apical IRADIAT AXILA
In rm acuta e protosistolic descrescendo(f simptomatic dar suflu mic)
In rm isvhemica-valva mitrala se ainchide oarecum excentric(ca foita post nu se inchide si se creeaza o problema de apozitie) deci fluxul e excentric spre aorta si nu spre peretele lateral al atriului stang=> iradiat superior parasternal stang sau in focarul aortic( DG DIF STENIZA AORTICA)
Z3
Cardiomegalie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dg dif rm ischemica

A

Stenoza aortica
Pt dif la efort izometric creste suflul la rm(auscultatie dinamica) de ex sa si stranga pumnul
Creste rez vasc perif=> creste pres vs=> accentueaza reg mitrala

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Rm si revarsatul oe o sg parte

A

Cica la ala sever merge mai mult spre vena pulm superioara drepata
Deci e afectat pl dr apical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Evaluare paraclinica

A

Ekg: hipertrofie as, vs

Rx: normal, confrstie, cardiomegalie

Eco: in special doppler pt jetul de regurgitare si vena contracta=grosime jet la originea lui

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Criterii de gravitate vm

A 
Bruschete aparitie
Suflu descrescendo
Z3
Vs>40
Fe<60
Grad rm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Prolaps valva mitrala

A

Deplasare spre AS
Click sistolic
Suflu telesistolic
Risc endocardita

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Rm ischemica

A

Valva ramane tractionata spre vs=>tenting

50:18=>

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Stenoza aortica

Etiologie

A

Cea mai frecevnta valvulopatie!!!
Raa
Bicuspidie
Degenerativa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Scleroza aortica

A

Ingrosarea valvei fara efect hemodinamic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Fr stenoza airtica

A 
Fumat
Barbat
Varsta
Hta
Hipercolesterol??
Diabet

Seamana cu cei ai ats ptc de multe ori chiar ats da stenoza airtica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Scleroza aortica anato pat

A

Fibroza si calcificare foite valvulare
Fuziune comisuri(in raa)
Structura contine lipide cel infl fibroblasti calciu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Ce fimensiune are o valva stenozata

A

1 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Fiziopat stenoza aortica

A

Sange in vs=> pres crescuta si volum crescut in vs=»»>
HIPERTROFIE CONCENTRICA COMPENSATORIE( scade stres parietal, scade complianta vs, creste pres de umplere diastolica, creste cons de oxigen)
Hipertrofie as compensatorie
Contractilitatea vs se mentine mult timp(disf sitolica+dilatare)
Gradient anormal vs ao

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Simpteome stenoza aortica

A

Dispnee
Angina(creste cons o2 si scade pres din aorta deci scade flux coronarian) pot exista si afectaru coronariane
Sincopa de efort

Cand exista simptome suprav la 2 ani e 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Clinic stenoza aortica

A

Suflu sitolic ejectional mezosistolic si iradiaza la carotide

Parvus et tardus(slab ca i pres mica in aorta)

Impuls apical crescut(ca i hipertrofie)

Z4 intarit(ca se contracta puternic atriul)

Z2 unic sau dedublat paradoxal(z2=aortic+pulm deci cand ai stenoza se prelungeste ejectia astfel incat poate sa depaseasca sau sa se suprapuna)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Paraclinic stenoza aorta

A

Ekg hvs si repolarizare

Rx hvs si dilatatie aorta poststenotica(flux turbulent care dilata)

Eco: ingrosare, calcificari, bucuspidie
Velocitate jet sitolic+gradient pres vs ao(bernouli) pt gradul regurgitarii>40 mmhge severa
Suprafata(ec de continuitate)
Hvs, fe, fct diastola

Cateterism gradient pres

Test de efort NU

Dopler velocitatea fluxului prin valva>4ms grav

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Criterii severitate strnoza aortica

A 
Simptome
Durata suflu sistolic
Sa muta(valve calcificate)
Supr <1cm
Grad pres mediu >40
Velocitate >4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Stenoza aortica low flow low gradient

A

Fe redusa, vs dilatat(ca o cmd)
S<1cm
Gradient <40mmhg
(Chir ca e severa pare ca i severa daca te iei dupa gradient)
Ca sa i maresc fe(gen volumul bataie) pt scurt timp pt a verifica ii fac TEST CU DOBUTAMINA(creste contractikitate si gradient) daca creste gradientul ins ca chiar e sever
Suflul e mai slab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Stenoza aortica paradoxal low flow low volume

A

Fe normala
Gradientul e mic ptc vs e mic
Gen la batrani hvs concentruca severa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Daca e o st aortica severa cu fe mica operez?

A

Nu ca nu suporta op
Mortalitatea mare
E bun candidat pt tavi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Tratament st aortica

A

Progreseaza 0,5 cm pe an
S a incercat statina dar meh
Nu sport
Diuretic, ieca, digitala, NU BETABLOC(scad inotropismu dar cu grija daca vr pt angina)

Proteze mecanice sau biologice
Autogrefa pulmonara

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Valvuloplastie percutana

A

Dilatare cu balon
Putin eficace la st aortica dar f buna la st mitrala
Bridge to surgery
Pac inoperabili
Pac tineri fara calcificari(st aortica congrnitala, raa)
Nu sch cursul natural al bolii

34
Q

Tavi

A

Dilat cu balon

Dar bag un fel de stent si in interior o valva

35
Q

Indicatii tavi

A 
Risc chirurgical crescut(euroscore 2)
Diverse comorbiditati, fragili
Pacienti >75 ani
Cu antecedente de chir cardiaca
Cu morfologie a valvei si a aortei favorabila! Si abord femural posibil
36
Q

Contraindicatii tavi

A

Inexistenta echipa
Inel airtic dimensiuni nepotrivite
Distanta prea mica intre inel si coronare
Endocardita
Trombi in vs
Bicuspidie aortica
Boala coronariana care necesita interventie

37
Q

Stenoza mitrala etiologie

A

Raa
Congenital
Calcificare inel mitral extinsa la valva
Simulata de mixom, vegetatii mari

38
Q

Stenoza mitrala anatomopat

A

Fibroza si calcificare foite valvulare
Fuziune comisuri valvulare
Fibroza si scurare cordaje

39
Q

Supraf normala v mirrala

A

4-6

Sub 2 e semnif hemodinamic

Vm capata forma de palnie prin fuziune

40
Q

Fizpat stenoza mitrala

A 
Creste pres as 
Creste pres vene si capilare
Transudat interstitiu si alveole
Dispnee
Se desch colateralele intre venele pulm si bronsice
HEMOPOTIZIE

Creste pasiv pres art pulm=>hipertrofie medie si fibroza intima=> creste rez arteriolar=> creste pres vd=>hipertrofie dilatatie icd

Htp

Prin cresterea pres in as=> fia
Stagnare sange prin fia=> embolie

41
Q

Clinic stenoza mitrala

A

Asimpt
Dispnee(efort, repaus, ortopnee, dispn paroxistica nocturna)
Icd
Fia, tep, endocardita, hemoptizie

42
Q

Clinic st mitrala

A

Impuls vd crescut
Z1 intarit(la vm mobila, dispare in stadii avansate)
ACMENT DE DESCHIDERE!
URUITURA DIASTOLICA

poate asocia reg mitrala, tricuspidiana, pulm, aortica
1:55=»>

43
Q

Putem interveni la asimptomatici valvulopatii?

A

Da daca au semne de progn prost gen fe super mic sau ventr dilatat

44
Q

Pres artera pulm calcul

A

Rrgurgitrarea tricuspidiana
P=4v la a 2

P+pad=pap

45
Q

Ce valva se imdexeaza la copr

A

Aorta

46
Q

Sa am grija la hta pac cand auscult pacientul. Dc?

A

Severitatea reg mitrala!

47
Q

Ceva ce n am inteles legat de reg mitr

A

Creste pres in vs daca cresc rvp
Ma gandeam ca creste postsarcina
Deci da poate d asta

48
Q

Fe supranormala cand si dc?

A

Reg mitrala
Ptc
E mai putin sange de ejectat deci il da afara mai usor
Si in plus
POSTSARCINA E MAI MICA PTC DEBITUL E SCAZUT

49
Q

Reg mitrala cronica cum sunt presiunile si ce se intampla

A

Pai pres oulmonara e normala ptc atriul s a dilatat si e compliant
Problema e ch debitul anterograg f mic

50
Q

Dc am dispnee la reg mitr

A

In primul rand in acut e epa cu congestie
In cronic fie la fresterea presiunilor fie la disfuntia contractila vs

Daca continua atunci pres crsscuta se transmite si in artera pulm=> semne de insuf dr!!

51
Q

Dg dif regurgitrare mitrala

A 
Stenoza aortica(inteleg si ca aortica se aude la mag stanga a sternului si focarul aortei) 
Fac ausc dinamica deci il pun sa faca efort izometric=>acc ref mirrala
52
Q

Eco rm

A

As si vs dilatate
Fe
Vena contracta=grosimea jetului la originea lui>7mm e sever-zona cea mai ingusta a jetului

53
Q

Tratament reg mitr

A

Acut: nitroprusiat si diuretic

Cronic: bb si spironolactona pt ic

Reparare mai ales la tineri
Protezare cu cordaje
Protezare standard fara cardoaje(daca fe eok)
Transcateter margine la margine

54
Q

Cand operez o reg mirrala

A

La simptome
Cand fe e nuca, pap>50, diaam sistolic>45
Are fia
Vas>69

55
Q

Eco reg aorta

A

Jet regurgitrare
Vena contracta
Pressure half time(in cat timp gradientul aovs se unjumatateste) daca i ra usoara e lent daca i sevrra e rapida

56
Q

Criterii severitate r ao

A

Bruschete aparitie
Suflu siatolic(ca ins ca e mare vol reg)
Z3(deci vs e dilatat)
Suflu protodiastolic descrescento acut

Vs sistolic>59
Fe<55
Gradient r ra

57
Q

Cand operez r ao

A

Simpt
Vs<50
Dilatate mare vs

Cum?
Repar valva cu anuloplastie la tineri cuvtricuspida supla
Inlocuiesc anevrismul>55
>50 daca are bicuspidie sau marfan
>45 la marfan nasoa, loeys (Adica pe scurt proteza valvulara+valva inclusa)
Sau pui proteza mecanica sau biologica
Aotogrefa ross

58
Q

Xare e cea mai frecv valvulop

A

Stenoza aortica

59
Q

Fiziopat stenoza aortica

A 
Creste ores vs
HIPERTROFIE CONCENTRICA(scade stres parietal, scade complianta vs=> creste pres de umplere diastola, creste consum o2)

HIPERTROFIE ASTRIU STANG

GRADIENT ANORMAL INTRE VS SI AO(mare mic)

Daca apare fia=> scade f mult contractilitatea

Mrg la final e o disf sist si diast (un vs dilatat pana la urma)

60
Q

Clinic stenoza aortica

A

Dispnee
Angina(creste consum, scade flux, afectare coronara)
Sincopa la efort (nu poate asigura debit si oricum e vasodil la efort deci scade presarcina) in repaus:aritmii

61
Q

Clinic stenoza aortica

A

Suflu mezosistolic ejectional iradiat carotine

Ouls parvus et tardus

Impuls palpabil

Zg 4

Zg2 unuc sau dedublat paradoxal

62
Q

Rx tenoza aorta

A

N are trb cu plamanii
Are dulatatie de aorta poststenotica
Hvs

63
Q

Cataterism fradient presiune

A

Partea hasurata intre p vs si pao

64
Q

Eco st aorta a zis profa ca

A

E un mod f bun de ev a presiunii din sistola

65
Q

Criterii gravitate st airta

A 
Simptome
Durata suflu 
Sa muta!
<1cm diam
Grad pres >40
Velocitate >4
66
Q

Sao low flow low gradient

A 
Va dilatat cu fe redusa
S<1cm
Suflu slab
Dar gradient mic 
Ptc daca fe e mica=> fluxul e mic=> nu ajunge la gradient

Ca sa vad daca asta e situatia asta trb sa i maresc fe sau volum bataie
Fac TEST CU DOBUTAMINA daca creste ins ca e st aortica severa

Daca nu creste fradientul atuncu poate are st aortica medie si cmd

67
Q

Sao paradoxal low flow low volume

A 
Fe normala
Dar oaradoxal e gradient mic
Dc?
Ptc ventriculul e mic
Hvs concentruca cu volum f mic=>volum bataie mic
N am ce examen sa fac
68
Q

Daca fe e 28% si stenoza aortica e severa e operabil?

A

Nu

Poate tavi

69
Q

Trat chir st aorta

A

Valvuloplastie nu prea
Proteze
Tavi-transcateter aortic valve implantation

70
Q

Cui fac tavi

A 
Risc chir crescut
Cu comorbiditati
Peste 75
Cu interventii cardiace antecedente
Cu morfo valva si fadacina aorta bune si abord femural posibil
71
Q

Contraindicatii tabi

A 
N au echipa
Tromb in vs
Inel airtic <18 sau >29
Dist mica untre aorta si coronarea
Endocardita
Bicuspidie
Boala coronara carr necesita revasc
72
Q

Supraf normala mirrala

A

4-6

Sub 2 nasol
Palnie

73
Q

Simptom caract stenoza mitrala

A

Hemoptizie!

74
Q

Fizpat st mitr

A

Practic 2 varinte
Fue face epa si hemoptizie
Fie care htp si are tot ingrosat pe acolo deci face icd

Fia prim intindere as

75
Q

Clinic st mitrala

A

Dispnee
Icd
(Fia, tep? Endocardita, hemoptizie)

76
Q

Semne icd

A

Vene jugulare
Reglux abdominojugulaascita
Edeme perif

77
Q

Clinic st mitr

A

Impuls vdmz1 intarit
CLACMENT DESCHIDERE
URIITURA DIASTOLICA

78
Q

Rx st mitrala

A 
Multa trb cu epa
Arc mijlociu bombat
Hipertrofie urechiusa sf
Had
Artera oulm dil
79
Q

Eco mod m st mitr

A

Aia cu fusiunile

80
Q

Complicatii st mitr

A

Fia
Embolii
Endocardita
Hemoptizii

81
Q

St mitr chir

A

Comisuritomie percutana cu balon
Comisuritonia chir
Protezare

Cardio (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions