[3] Valvular Heart Disease in Adults Flashcards Preview

[OS 213] CVS Module > [3] Valvular Heart Disease in Adults > Flashcards

Flashcards in [3] Valvular Heart Disease in Adults Deck (40):
1

Define: Stenosis

Narrowing of heart valve

2

Define: Regurgitation

Failure of heart valve to close

3

Normal MV Orifice
Significant Obstruction

N: 4-6cm^2

SO: <2cm^2

4

Smallest MV Orifice Compatible With Life

0.3cm^2

5

[Pathophysiology of MS]

Left Atrium and Pulmonary Artery Wedge Pressure

Increased

Prominent A waves and gradual Y descent

6

[Pathophysiology of MS]

Left Ventricular End Diastolic Pressure

Normal in MS

7

[Pathophysiology of MS]

Cardiac Output

May be normal but generally worsens progressively

8

[Symptoms and Complications]

Mitral Stenosis

1. Exertional Dyspnea, Orthopnea, PND
2. Acute Pulmonary Edema
3. Atrial Arrythmias
4 Hemoptysis

9

[Physical Findings]

Inspection of Mitral Stenosis

1. Malar flush with pinched and blue facies
2. Prominent alpha waves in JVP in sinus rhythm
3. Single c-v wave in AF

10

[Physical Findings]

Palpation of Mitral Stenosis

1. Right ventricular tap with palpable S1
2. Diastolic Trill

11

[Physical Findings]

Auscultation of Mitral Stenosis

Describe:
S1
P2

Low-pitched, rumbling, diastolic murmur

Accentuated and Snapping S1
Accentuated P2 in pulmonary hypertension
Opening snap follows P2

12

[Laboratory Examination]

ECG of Mitral Stenosis

Left and Right Atrial Enlargement
Right Axis Deviation
Right Ventricular Enlargement

13

What is the most sensitive and specific non-invasive method for diagnosis of Mitral Stenosis?

Echocardiogram

14

Using cardiac catheterization should be applied in what age for Filipinos?

Males: > 55 yo
Females: > 60 yo

15

Mitral Regurgitation is commonly caused by?

Chronic RHD in 90% of Cases

16

Effect of MR on the LA and LV

Enlargement in both, the larger the LV gets, the worse the MR becomes

17

[Auscultation of Mitral Regurgitation]

Describe Murmur

Grade III/IV Holosystolic Murmur at Apex and Radiates to Axilla

18

[Auscultation of Mitral Regurgitation]

Describe S sounds

S1 Absent or Soft
S2 Widely Split
S3 Due to sudden tensing of papillary muscles
S4 Audible

19

What is the most sensitive and specific non-invasive method for diagnosis of Mitral Regurgitation?

Echocardiogram

20

Why do you give vasodilators to people with MR?

Lower the afterload

21

Define: Critical Aortic Stenosis

Peak systolic pressure gradient of 50mmHg
AV Area < 0.5 cm^2

22

[Aortic Stenosis]
CO at Rest
CO with Exercise

Normal
Subnormal Rise

23

Why do you not perform Percutaneous Balloon Aortic Valvuloplasty on the elderly?

Usually have calcifications and this might cause an embolism

24

Marfan's Syndrome usually causes what valvular disease?

Aortic Regurgitation

25

[Auscultation of Aortic Regurgitation]

Describe Murmur

High-pitched, blowing, decrescendo diastolic murmur

26

How do you intensify Aortic Regurgitation murmurs? How does this happen?

Handgrip Maneuver

Increases the afterload, causing more regurgitation to occur

27

What would cause increase in the sound of a murmur in Tricuspid Stenosis?

Inspiration

Causes increased amounts of blood to flow into the heart, causing a larger sound

28

Do you replace the Tricuspid Valve?

No, because low blood flow would make it prone to infection and increased chances of thrombus infection

29

Why would Mitral Stenosis cause Hoarseness of Voice

Enlargement of LA can compress the Left Recurrent Laryngeal Nerve

30

Pulsus parvus et tardus is found in which Valvular Disease?

Aortic Stenosis

31

Bisferiens pulse is found in which Valvular Disease?

Aortic Stenosis

32

Murmur heard in Aortic Stenosis

Systolic Crescendo-Decrescendo Murmur

33

What is Demusset's Sign

Jarring of entire body
Head bobbing with each systole

34

What is Corrigan's Pulse

"Water Hammer Pulse"
Collapses as arterial pressure falls rapidly during late systole and diastole

35

What is Traube's Sign

Pistol shot pulse heard over femoral artery

36

What is Quicke's Pulse

Capillary pulsations when pressure is applied to the nail

37

What is Durozier's Sign

To-and-fro murmur with femoral artery compression

38

Austin-Flint Murmurs are heard during which kind of Valvular Disease?

Mitral Regurgitation

39

Carvallo's Sign is usually heard during what kind of Valvular Disease?

Tricuspid Regurgitation

40

What is Carvallo's Sign?

Holosystolic murmurs intensified by inspiration