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critical care exam 2 but better > vascular > Flashcards

vascular Flashcards

1
Q

what are chordae tendineae

A

Fibrous tissue that anchor valve leaflets to papillary muscles of the ventricles

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2
Q

what is regurgitation

A

When valves do not close completely when they are supposed to close

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3
Q

what is stenosis

A

When valves do not open completely when they are supposed to open

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4
Q

what is the difference in the mitral valves?

A

The anterior leaflet is longer

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5
Q

what happens in mitral valve prolapse

A

A portion of one or both mitral valve leaflets balloons back into the atrium during systole leading to regurgitation

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6
Q

what heart sound can be heard in patients with mitral valve prolapse

A

Extra heart sound: mitral click

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7
Q

what are patients with mitral valve prolapse at increased risk for

A

Endocarditis

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8
Q

What antibiotic prophylaxis is recommended for high-risk patients before and after dental procedures?

A

amoxicillin

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9
Q

what can cause mitral regurgitation?

A

Thickness and fibrosis of the chordae tendineae → they pull on the leaflet so it can’t close
Developing countries: rheumatic heart disease
Developed countries: degenerative changes of the mitral valve

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10
Q

what are the symptoms of mitral regurgitation

A

Dyspnea, fatigue, weakness, clots, stroke

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11
Q

what kind of murmur does mitral regurgitation cause

A

High-pitched blowing sound at the apex on systole

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12
Q

what is the treatment for mitral regurgitation

A

Reduce afterload (same for HF)

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13
Q

what causes mitral stenosis

A

Obstruction of the blood flowing from the left atrium to the left ventricle due to the narrowing of the mitral valve orifice

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14
Q

what are the symptoms of mitral stenosis

A

low-key everything?
enlarged left atrium → dry cough wheezing and afib, hemoptysis, palpitations, orthopnea, paroxysmal nocturnal dyspnea, repeated infections

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15
Q

what kind of murmur does mitral stenosis have

A

low pitched rumbling diastolic

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16
Q

what is the surgical intervention for mitral stenosis

A

Percutaneous transluminal balloon valvuloplasty → child-bearing aged women

17
Q

what causes aortic regurgitation

A

flow of blood back into the left ventricle from the aorta during diastole

18
Q

what are the symptoms of aortic regurgitation

A

Marked arterial pulsations visible or palpable at carotid or temporal arteries
Forceful heartbeat especially in head or neck

19
Q

what kind of murmur does aortic regurgitation have

A

High-pitched, blowing diastolic murmur at the third or fourth intercostal space at the left sternal border

20
Q

what happens to the blood pressure of a patient with aortic regurgitation

A

widened pulse pressure

21
Q

what is the medical management of aortic regurgitation

A

Afterload reduction, sodium restriction, and avoid fluid overload

22
Q

when would surgical management be recommended for a patient with aortic regurgitation

A

left ventricular dilation

23
Q

what kind of murmur does aortic stenosis have

A

Loud, harsh systolic murmur heard over the aortic area and may radiate to the carotid arteries and apex of the carotid arteries and apex of the left ventricle
Low-pitched, crescendo-decrescendo, rough, rasping, and vibrating

24
Q

what is the prevention for aortic stenosis

A

control risk factors for proliferative and inflammatory responses

25
Q

what are the types of valvuloplasty

A

commissurotomy, closed, open, annuloplasty, and leaflet repair

26
Q

what is commissurotomy

A

procedure performed to separate the fused leaflets

27
Q

what is closed valvuloplasty and who is it beneficial for

A

Balloon valvuloplasty → younger patients with mitral valve stenosis

28
Q

What are the contraindications for a closed valvuloplasty?

A

Left atrial or ventricular thrombus, severe valvular calcifications, thoracolumbar scoliosis, rotation of the great vessels, open heart surgery

29
Q

what is annuloplasty

A

repair of the valve annulus

30
Q

what are the types of leaflets repair

A

Elongated: folded over onto itself and suture
Short leaflets: chordoplasty (repair of the chordae tendineae)
Holes: pericardial or synthetic patch may be used

31
Q

what is the easiest valve to repair

A

Mitral valve, the rest should be replaced instead → aortic has a 50% restenosis 6 months later

32
Q

what are the complications of a mitral balloon valvuloplasty

A

mitral regurgitation, bleeding from insertion site, emboli, ventricular perforation,

33
Q

what are the two types of valve replacements

A

mechanical
More durable
Less likely to be infected
Need anticoagulants

Tissue
- Bioprosthesis: from pigs,
cows, or horses
- Homografts: human valves
- Autografts: patient’s own
pulmonic valve
- Less likely to generate
thromboemboli and long-
term anticoagulation is not
required

critical care exam 2 but better (8 decks)

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