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` > Pulmonic, Tricuspid, Prosthetic valves > Flashcards

Pulmonic, Tricuspid, Prosthetic valves Flashcards

1
Q

Are mild and moderate PR “normal variants?”

A

Yes

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2
Q

3 causes of severe PR

A

Carcinoid
TOF
Endocarditis

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3
Q

In severe PR, where color jet fills RVOT, what will the CW deceleration slope look like?

A

Steep (may end abruptly)

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4
Q

Most common etiology of Tricuspid Stenosis

A

Rheumatic

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5
Q

JVP in TS

A

Giant a- wave

Diminished y descent

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6
Q

What vena contracta is considered severe for all valvular regurge?

A

> .7cm

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7
Q

What stage is severe, asxs TR (VC>.7cm, hepatic vein systolic flow reversal)?

A

C

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8
Q

What stage is severe sxs TR (vena contracta>.7cm, hepatic vein systolic reversal)?

A

D

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9
Q

What do CW jet density and contour look like in severe TR?

A

Dense

Triangular with early peak

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10
Q

When is TV repair a class I indication for severe TR?

A

At time of left sided valve Sx

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11
Q

Is pressure half time in severe MS long or short?

A

Long

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12
Q

Is pressure half time in severe AI long or short?1

A

Short

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13
Q

Sxs: flushing, diarrhea, wheezing. Dx? What percent of pt’s develop cardiac involvement?

A

Carcinoid

50%

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14
Q

Test for carcinoid

A

24h urine 5-HIAA

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15
Q

What valve lesion commonly occurs with carcinoid?

A

TS

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16
Q

Migraine Rx similar to carcinoid except causes more left sided valve lesions

A

Ergotamine

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17
Q

What left sidd lesions do radiation and antiphospholipid Ab syndromes usually cause?

A

AR, MR

18
Q

What bug requires only a single Cx to be considered a major criteria for endocarditis?

A

Coxiella burnetti

19
Q

3 echo findings,besides veg, that count as major criteria for endocarditis

A

New regurgitation
New partial prosthetic valve dehiscence
Abscess

20
Q

Typical organisms causing endocarditis

A

Staph aureus
Strep viridans
Strep G, A, C
enterococcus

21
Q

Which resistant organisms require early surgery for endocarditis?

A

Staph aureus

Fungi

22
Q

What is considered a large vegetation on echo?

A

> 1cm

23
Q

Name 4 reasons in endocarditis to do early Sx

A 
Valve dysfxn/LV dysfxn
Resistant org (s. aureus, fungi)
Heart block/ abscess
Persistent infection
Increased LVEDP
24
Q

Abx regimen for endocarditis ppx

A

Amoxicillin 2g

Cephalosporins or clinda if allergy

25
Q

Under age 60, what type of prosthetic valve is recommended?

A

Mechanical

26
Q

After age 70, what type of prosthetic valve is recommended?

A

Bio

27
Q

If you detect regurgitation of a prosthetic valve, how often do you do followup echoes?

A

q 3-6 mo’s

28
Q

What are 3 risk factors for thrombosis of prosthetic valve?

A

AF
previous thromboembolic event
Low EF

29
Q

All patients with a prosthetic valve (bio or mech) should get what med?

A

ASA 81

30
Q

What anticoagulatuon or ASA do you do for a patient with a bio prosthetic valve and 1 risk factor?

A

Coumadin

31
Q

What is INR goal for mech AVR and no risk factors?

A

2-3

32
Q

What do you do if patient has a thromboembolic event with prosthetic valve when INR was 2.5-3.5?

A

Inc goal to 3.5-4.5

33
Q

Which type of prosthetic valve does not require heparin or lovenox bridge for Sx?

A

Mechanical AVR

34
Q

Who usually gets patient-prosthesis mismatch?

A

Older women (LOL)

35
Q

Which type of prosthetic valve is at greatest risk for thrombosis?

A

TV

36
Q

Which prosthetic valves do better with thrombolytics?

A

Right sided valves

37
Q

According to prosthetic valve thrombosis guidelines, when is it ok to give fibrinolytics?

A

Recent onset , NYHA class I-II sxs, small thrombus

38
Q

What prosthetic valve is at greatest risk of endocarditis?

A

MVR

39
Q

When after a prosthetic valve placement, is the greatest risk of endocarditis?

A

First 6 months

40
Q

Vmax and peak instantaneous gradient associated with severe PS

A

Vmax> 4

PIG> 64 mmHg

` (31 decks)

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