Vavular Heart Disease Flashcards

1
Q

Common symptoms of Valve disease?

A

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

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2
Q

What is cardiac breathlessness associated with?

A

activity and ankle swelling
orthopnoea
Paroxysmal Nocturnal Dysnopnoes (PND)

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3
Q

What is Class I NYHA?

A

no limitation

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4
Q

What is NYHA Class 2?

A

slight limitation of ordinary activity

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5
Q

What is Class 3 NYHA/

A

Marked limitation of less than ordinary activity

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6
Q

What is class IV NYHA?

A

Severe limitation of minimal activity or at rest

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7
Q

Signs of Right sided Heart Failure

A

raised JVP
Pitting Oedema
Hepatic Congestion

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8
Q

Describe the apex beat in mitral stenosis?

A

tapping

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9
Q

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

A

volume overload

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10
Q

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

A

pressure overload

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11
Q

What is a parsternal Heave indicative of?

A

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

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12
Q

What is a cardiac murmur?

A

audible turbulence of blood flow

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13
Q

How is a murmur described?

A
Systole or diastole?
What type of murmur?
Where is it loudest?
Where does it radiate to?
What grade of murmur?
(Influenced by respiration?)
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14
Q

Which murmurs can you hear in systole?

A

aortic stenosis

mitral regurgitation

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15
Q

Which murmurs can you hear in diastole?

A

aortic regurgitation

mitral stenosis

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16
Q

describe a pansystolic murmur?

A

a continuous sound that continues throughout systole

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17
Q

How are the murmurs volume graded?

A

I-VI

quiet-loud

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18
Q

What side of the heart murmers are louder with inspiration?

A

right-sided murmurs

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19
Q

Where are innocent murmurs normally heard?

A

often soft early systolic sound

20
Q

d: valve stenosis

A

Valves which do not open properly

21
Q

d: valve regurgitation

A

Valves which do not close properly

22
Q

d; mixed valve disease

A

Valves which neither open properly nor close properly

23
Q

Causes of Aortic Stenosis

A

degenerative
congenital eg bicuspid valve
rheumatic

24
Q

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

A

more turbulent blood flow cos 2 cusps instead of 3

25
clinical findings of aortic stenosis?
Low volume pulse Forceful displaced apex Ejection systolic murmur that can radiate to the carotids
26
what disease to patients have commonly who have aortic stenosis?
Left ventricular hypertrophy
27
What does an ECG of aortic stenosis look like?
LVH
28
Treatment of Aortic Stenosis
Conventional valve replacement Trans catheter aortic valve replacement (TAVI) Balloon Aortic valvotomy (BAV)
29
Why are bio-prosthetic valves given?
no warfarin
30
Causes of Mitral Reguritation
``` Leaflets; -Prolapse -Rheumatic -Myxomatous (floppy) -Endocarditis Chordae rupture: (degenerative) -Prolapse/flail leaflet Papillary muscles rupture: -Ischaemic Annular dilatation: -Functional ```
31
symptoms mitral regurgitation
Breathlessness Peripheral oedema Fatigue
32
Clinical findings of mitral regurgitation
Displaced apex Pansystolic murmur Axilla
33
What does mitral regurgitation on CXR/
cardiomeagly
34
Treatment of Mitral regurgitation
Medication -Diuretics and heart failure (ACE inhibitors) Surgical - Repair – prolapse - Replacement - degenerative Percutaneous Clips in infancy – encouraging results
35
Causes Mitral Stenosis
Essentially rheumatic main cause | Congenital rare
36
Symptoms Mitral Stenosis
Breathlessness Fatigue Palpitations (AF)
37
Clinical Findings for mitral stenosis
Malar flush Tapping apex beat Mid diastolic rumbling diastolic murmur localised to apex
38
What would an ECG show for mitral stenosis?
atrial fibrillation
39
What would a CXR show for mitral stenosis?
straight left heart border
40
Treatment for mitral stenosis
``` Medication -Diuretics and treat AF Surgery -Valve replacement Balloon Valvuloplasty ```
41
causes for aortic regurgitation
Leaflets: - Endocarditis - Connective tissue diseases - Rheumatic Annulus: - Marfans - Aortic dissection
42
Symptoms Aortic regurgitation
breathlessness
43
clinical findings of aortic regurgitation
Collapsing pulse Wide pulse pressure Displaced apex Early diastolic murmur left sternal edge
44
What does CXR show for aortic regurgitation?
cardiomegaly
45
Treatment for aortic regurgitation
Medication -ACE inhibitors Surgery - Symptoms and LV dilatation - Valve replacement