Vavular Heart Disease

Question 1

Common symptoms of Valve disease?

Answer 1

chest pain - gripping, squeezing, heavy
breathlessness
collapse/dizzy spell

Question 2

What is cardiac breathlessness associated with?

Answer 2

activity and ankle swelling
orthopnoea
Paroxysmal Nocturnal Dysnopnoes (PND)

Question 3

What is Class I NYHA?

Answer 3

no limitation

Question 4

What is NYHA Class 2?

Answer 4

slight limitation of ordinary activity

Question 5

What is Class 3 NYHA/

Answer 5

Marked limitation of less than ordinary activity

Question 6

What is class IV NYHA?

Answer 6

Severe limitation of minimal activity or at rest

Question 7

Signs of Right sided Heart Failure

Answer 7

raised JVP
Pitting Oedema
Hepatic Congestion

Question 8

Describe the apex beat in mitral stenosis?

Answer 8

tapping

Question 9

If the apex beat is displaced and diffuse in Left ventricular dilatation, what is happening?

Answer 9

volume overload

Question 10

Heaving and apex beat is displaced in LVH, what is happening?

Answer 10

pressure overload

Question 11

What is a parsternal Heave indicative of?

Answer 11

Hand left of sternum
Right ventricular overload
cor pulmonale/pulmonary hypertension

Question 12

What is a cardiac murmur?

Answer 12

audible turbulence of blood flow

Question 13

How is a murmur described?

Answer 13

Systole or diastole?
What type of murmur?
Where is it loudest?
Where does it radiate to?
What grade of murmur?
(Influenced by respiration?)

Question 14

Which murmurs can you hear in systole?

Answer 14

aortic stenosis

mitral regurgitation

Question 15

Which murmurs can you hear in diastole?

Answer 15

aortic regurgitation

mitral stenosis

Question 16

describe a pansystolic murmur?

Answer 16

a continuous sound that continues throughout systole

Question 17

How are the murmurs volume graded?

Answer 17

I-VI

quiet-loud

Question 18

What side of the heart murmers are louder with inspiration?

Answer 18

right-sided murmurs

Question 19

Where are innocent murmurs normally heard?

Answer 19

often soft early systolic sound

Question 20

d: valve stenosis

Answer 20

Valves which do not open properly

Question 21

d: valve regurgitation

Answer 21

Valves which do not close properly

Question 22

d; mixed valve disease

Answer 22

Valves which neither open properly nor close properly

Question 23

Causes of Aortic Stenosis

Answer 23

degenerative
congenital eg bicuspid valve
rheumatic

Question 24

How does a congenital defect of biscuspid valve cause aortic stenosis?

Answer 24

more turbulent blood flow cos 2 cusps instead of 3

Question 25

clinical findings of aortic stenosis?

Answer 25

Low volume pulse
Forceful displaced apex
Ejection systolic murmur that can radiate to the carotids

Question 26

what disease to patients have commonly who have aortic stenosis?

Answer 26

Left ventricular hypertrophy

Question 27

What does an ECG of aortic stenosis look like?

Answer 27

LVH

Question 28

Treatment of Aortic Stenosis

Answer 28

Conventional valve replacement
Trans catheter aortic valve replacement (TAVI)
Balloon Aortic valvotomy (BAV)

Question 29

Why are bio-prosthetic valves given?

Answer 29

no warfarin

Question 30

Causes of Mitral Reguritation

Answer 30

Leaflets;
-Prolapse
-Rheumatic
-Myxomatous (floppy)
-Endocarditis
Chordae rupture: (degenerative)
-Prolapse/flail leaflet
Papillary muscles rupture:
-Ischaemic
Annular dilatation: 
-Functional

Question 31

symptoms mitral regurgitation

Answer 31

Breathlessness
Peripheral oedema
Fatigue

Question 32

Clinical findings of mitral regurgitation

Answer 32

Displaced apex
Pansystolic murmur
Axilla

Question 33

What does mitral regurgitation on CXR/

Answer 33

cardiomeagly

Question 34

Treatment of Mitral regurgitation

Answer 34

Medication
-Diuretics and heart failure (ACE inhibitors)

Surgical

• Repair – prolapse
• Replacement - degenerative

Percutaneous
Clips in infancy – encouraging results

Question 35

Causes Mitral Stenosis

Answer 35

Essentially rheumatic main cause

Congenital rare

Question 36

Symptoms Mitral Stenosis

Answer 36

Breathlessness
Fatigue
Palpitations (AF)

Question 37

Clinical Findings for mitral stenosis

Answer 37

Malar flush
Tapping apex beat
Mid diastolic rumbling diastolic murmur localised to apex

Question 38

What would an ECG show for mitral stenosis?

Answer 38

atrial fibrillation

Question 39

What would a CXR show for mitral stenosis?

Answer 39

straight left heart border

Question 40

Treatment for mitral stenosis

Answer 40

Medication
-Diuretics and treat AF
Surgery
-Valve replacement
Balloon Valvuloplasty

Question 41

causes for aortic regurgitation

Answer 41

Leaflets:

• Endocarditis
• Connective tissue diseases
• Rheumatic

Annulus:

• Marfans
• Aortic dissection

Question 42

Symptoms Aortic regurgitation

Answer 42

breathlessness

Question 43

clinical findings of aortic regurgitation

Answer 43

Collapsing pulse

Wide pulse pressure

Displaced apex

Early diastolic murmur left sternal edge

Question 44

What does CXR show for aortic regurgitation?

Answer 44

cardiomegaly

Question 45

Treatment for aortic regurgitation

Answer 45

Medication
-ACE inhibitors

Surgery

• Symptoms and LV dilatation
• Valve replacement