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CVPR Exam I COPY > 29. Mitral and Tricuspid Valve Disease > Flashcards

29. Mitral and Tricuspid Valve Disease Flashcards

1
Q

How do you treat mitral valve regurg?

A
  1. diuretics for CHF 2. ACE inhibitors or ARBs for afterload reduction 3. mitral valve repair or replacement surgery
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2
Q

How is mitral stenosis treated?

A
  1. beta blockers to slow HR 2. diuretics for CHF 3. anticoagulants if A-fib 4. valve replacement 5. percutaneous balloon
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3
Q

What are the diastolic murmurs?

A
  1. aortic regurgitation 2. mitral stenosis
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4
Q

What are the s/s of mitral regurg?

A

CHF, dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, edema

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5
Q

When is S3 abnormal? What does it indicate?

A

in older people; heart disease, like CHF

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6
Q

Where is an aortic regurgitation murmur heard?

A

along the L sternal border

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7
Q

Describe an aortic regurgitation murmur.

A

an early diastolic S2 murmur that decrescendos, heard along the L sternal border

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8
Q

What is a diastolic rumble?

A

a low freq decrescendo murmur due to turbulent flow across the stenotic mitral valve during diastole

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9
Q

How is tricuspid stenosis treated?

A
  1. diuretics 2. surgery
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10
Q

What is tricuspid stenosis?

A

a rare hardening of the tricuspid valve, usually from Rheumatic heart disease

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11
Q

____% of mitral stenosis cases are rheumatic.

A

80

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12
Q

When do symptoms of valve dysfunction post-Rheumatic fever present?

A

10-30 years later

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13
Q

What are the echo findings of mitral stenosis?

A
  1. LA enlargement 2. restricted opening of MV during diastole 3. thickened MV leaflets
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14
Q

What is the most common cause of mitral stenosis?

A

Rheumatic HD

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15
Q

What is mitral valve prolapse?

A

valve flaps pushed the wrong direction until they’re caught by the chordae tendinae

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16
Q

______ leads to chronic rheumatic heart disease.

A

Inflammation of the vascular endocardium

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17
Q

What is JVD with visable systolic V wave, hepatomegaly, and a holosystolic murmur along the sternal border that increases intensity with inspiration indicative of?***

A

tricuspid regurg

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18
Q

______ leads to increased pressure w/I the LA, pulmonary vasculature, and R heart.

A

Mitral valve stenosis

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19
Q

What causes the loud S1 in mitral stenosis?

A

forceful closing of the mitral valve

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20
Q

How is the severity of mitral stenosis determined?

A

use echo to measure or visualize

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21
Q

How does tricuspid stenosis sound?

A

an opening snap followed by a mid-diastolic rumble

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22
Q

Mitral valve stenosis leads to ______.

A

increased pressure w/I the LA, pulmonary vasculature, and R heart.

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23
Q

What is S4?

A

a pressure overload condition heard due to atrial contraction into concentric hypertrophy of the ventricle; always pathological

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24
Q

What part of the mitral valve is abnormal to cause MV regurg?

A

any part (annulus, leaflets, chordae, pap muscles)

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25
Q

What are the buzzwords for tricuspid regurg?

A

JVD with visable systolic V wave, hepatomegaly, holosystolic murmur along the sternal border that increases intensity with inspiration

26
Q

Elevated RA pressure leads to _____.

A

increased venous pressure

27
Q

Where would a tricuspid stenosis murmur be heard?

A

near the sternum and it would intensify with inspiration

28
Q

What causes an opening snap?

A

stiff mitral valve flaps shooting open during rapid filling phase

29
Q

What is mitral stenosis?

A

stiffening of the mitral valve that doesn’t allow blood through well

30
Q

When would you treat mitral valve stenosis?

A
  1. when the pt is symptomatic 2. if the pt has pulm HTN 3. if the pt has A-fib
31
Q

What can cause tricuspid regurg?

A
  1. a congenital structure abnormality 2. endocarditis 3. heart disease 4. Rheumatic fever 5. radiation 6. drugs
32
Q

What does a midsystolic click followed by a late systolic murmur indicate?

A

mitral valve prolapse

33
Q

What is aortic regurgitation?

A

blood comes backwards thru the aortic valve to the LV

34
Q

What is acute rheumatic fever?

A

an inflammatory condition involving the heart, skin, and/or CT 2a to a group A strep infection

35
Q

What can damage the mitral valve and therefore cause MV regurg?

A
  1. myxomatous degeneration 2. ischemic heart disease 3. endocarditis 4. Rheumatic heart disease 5. LV enlargement (stretches out MV)
36
Q

How does a mitral stenosis murmur sound?

A

a diastolic murmur starting right after at S2 with an opening snap and then decrescendo with a pre-systolic accentuation

37
Q

When is S3 normal?

A

in young people

38
Q

The ____ valve opens in diastole, allowing blood to flow from the LA to the LV.

A

mitral

39
Q

What are the EKG findings of mitral stenosis?

A
  1. LA enlargement 2. RVH if pulm HTN has developed 3. possible A-fib
40
Q
  1. LA enlargement 2. RVH if pulm HTN has developed 3. possible A-fib
A

EKG findings of mitral stenosis

41
Q

What is tricuspid regurg?

A

tricuspid valve doesn’t close completely during systole, allowing blood to flow backwards into the RA

42
Q

What is a loud S1 with an opening snap and a diastolic rumble indicative of?***

A

mitral stenosis

43
Q

How are S3 and S4 heard best?

A

at the apex in the L lateral decubitus position

44
Q
  1. LA enlargement 2. restricted opening of MV during diastole 3. thickened MV leaflets
A

echo findings for mitral stenosis

45
Q

When is the opening snap heard?

A

after S2

46
Q

Name 6 s/s of mitral stenosis.

A
  1. dyspnea 2. hemoptysis 3. pulmonary HTN 4. R sided heart failure 5. A-fib 6. thromboembolism
47
Q

How is a mitral stenosis murmur described?

A

an opening snap followed by a mid-diastolic rumble

48
Q

Name the 4 parts of the mitral valve.

A
  1. Annulus 2. Leaflets 3. Chordae 4. Papillary muscles
49
Q

What is S3?

A

a volume overload condition heard in early diastole during the rapid filling phase caused by tensing of chordae tendinae; can be normal in young people

50
Q

What is another name for S3?

A

a ventricular gallop

51
Q

What sound does mitral valve prolapse cause?

A

a nonejection click that is mid- to late-systolic and then a murmur of regurgitation

52
Q

What is another name for S4?

A

an atrial gallop

53
Q

Describe a pulmonic regurgitation murmur.

A

an early S2 murmur that decrescendos, heard along the upper left sternal border

54
Q

Describe the murmur in mitral valve prolapse.

A

a mid-systolic click with a late-systolic murmur (btw S1 and S2)

55
Q

How is tricuspid regurg treated?

A
  1. treat the underlying cause, if possible 2. diuretics 3. tricuspid repair/replacement surgery
56
Q

What does a holosystoic murmur at the apex with radiation to the axilla indicate?

A

mitral valve regurg

57
Q

The mitral valve opens in _____, allowing blood to flow from the LA to the LV.

A

diastole

58
Q

What causes the opening snap in mitral stenosis?

A

opening of the stenotic mitral leaflets

59
Q

What is mitral regurg?

A

inadequate mitral valve closure, so blood is allowed to flow backward from the LV to the LA

60
Q

Inflammation of the vascular endocardium leads to _____.

A

chronic rheumatic heart disease

CVPR Exam I COPY (29 decks)

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