valvular disorders Flashcards
What are causes of aortic stenosis?
in order: congenital defect, rheumatic heart disease, calcification, teritary syphilis
What are common symptoms of aortic stenosis? What maneuvers decrease the murmur?
chest pain, SOB, syncope. valsalva decreases the maneuver
mitral regurgitation causes; murmur
mitral valve prolapse, RHD, papillary muscle dysfunction, endocarditis, LV dilation. blowing holosystolic murmur with wide S2
Tx for mitral regurg
vasodilators if symptomatic, consider prophylactic abx, and prophylactic anticoagulation
what are the causes of aortic regurg?
congenital defect, endocarditis, RHD, tertiary syphilis, aortic root dilation (possibly from aortic dissection)
What are the treatments for aortic regurg?
ACE-I, CCB, nitrates- decrease afterload; valve replacement
How do you tell HOCM apart from aortic stenosis?
in aortic stenosis, valsalva decreases in the murmur; in HOCM, valsalva increases it
How do you differentiate restrictive cardiomyopathy from a constrictive pericarditis?
CT or MRI
What is hypertrophic cardiomyopathy?
verntricular hypertrophy with thickened septum. leads to decreased filling, LV outflow obstruction and both systolic and diastolic dysfunction. causes syncope, dyspnea, palpitations, chest pain, and symptoms that worsen with exercise.
this is a largely familial condition caused by abnormal cardiac sarcomere proteins
what are the finding on exam for hypertrophic cardiomyopathy?
S4, systolic murmur, apical impulse, EKG with possible arrhythmia, LVH, abnormal Q waves
what are the treatments for hypertrophic cardiomyopathy?
BBs, CCBs, pacemake, partial septal excision
What are causes of dilated cardiomyopathy?
idiopathic is most common also related to: drugs (cocaine, doxorubicin, alcohol) nutrition (beriberi infection- coxsachie B, HIV, chagas disease pregnancy hemochromatosis ischemia FA reminder: ABCCCD: alcohol, beriberi, cocaine, chagas, coxsackie B, doxorubicin
what are the symptoms of dilated cardiomyopathy?
S3, systolic and diastolic murmurs, balloon-like heart
what are the treatments for dilated cardiomyopathy?
stop alcohol and cocaine, diuretics, ACE-I, BB, anticoagulation
What is restrictive cardiomyopathy?
decreased heart compliance causes impaired diastolic filling. casued by amyloidosis and sarcoidosis, rarely loffler syndrome *endomyocardial fibrosis with eosinophilic infiltrates), radiation. In kids can be caused by fibroelastosis
