Valvular Disease

Question 1

Heart Sounds 1 + 2 are made by which valves

Answer 1

HS 1 “lub” = closure of mitral and tricuspid valves

HS 2 “dub” = closure or pulmonary and aortic valves

Question 2

Aortic Stenosis Sounds

Answer 2

Heard Aortic area and Apex
Radiates to Carotids
Ejection sytolic murmur (crescendo) with ejection click

Question 3

Aortic Regurgitation Sounds

Answer 3

Heard Left Sternal edge 
radiates to apex
Early diastolic murmor
Loud then decrescendos
"Austin Flint"

Question 4

Heard Left Sternal edge 
radiates to apex
Early diastolic murmor
Loud then decrescendos
"Austin Flint"

Answer 4

Aortic Regurgitation

Question 5

Heard Aortic area and Apex
Radiates to Carotids
Ejection sytolic murmur (crescendo) with ejection click

Answer 5

Aortic Stenosis

Question 6

Mitral Stenosis Sounds

Answer 6

Heard at mitral area (apex)
Mid diastolic
low pitched
with high pitched opening snap

Question 7

Heard at mitral area (apex)
Mid diastolic
low pitched
with high pitched opening snap

Answer 7

Mitral stenosis

Question 8

Mitral Regurgitation Sounds

Answer 8

Hear at apex
Radiates left axilla
Pansystolic murmur of continuous intensity
midsystolic click

Question 9

Hear at apex
Radiates left axilla
Pansystolic murmur of continuous intensity
midsystolic click

Answer 9

Mitral Regurgitation

Question 10

Pulmonary Stenosis sounds

Answer 10

Heard pulmonary area (left sternal edge)
Radiates to left clavical
Ejection systolic crescendo murmour

Question 11

Heard pulmonary area (left sternal edge)
Radiates to left clavical
Ejection systolic crescendo murmour

Answer 11

Pulmonary stenosis

Question 12

Tricuspid Regurg sounds

Answer 12

Lower right sternum
Radiates to liver and back
Pansystolic

Question 13

Lower right sternum
Radiates to liver and back
Pansystolic

Answer 13

Tricuspid Regurgitation

Question 14

Ventricular Septal defect sounds

Answer 14

Loudest at left sternal edge
radiates through whole precordium
Pansystolic

Question 15

Loudest at left sternal edge
radiates through whole precordium
Pansystolic

Answer 15

VSD

Question 16

Symptoms of Aortic Stenosis

Answer 16

Chest pain
SOB
pre-syncope, syncope and fatigue
progresses, initially only symptomatic on exertion

Question 17

Symptoms Aortic Regurgitation

Answer 17

Pounding
Angina 
breathlessness 
Collapsing Waterhammer pulse
eventually LVH and signs of LHF

Question 18

Symptoms Mitral Stenosis

Answer 18

Recurrent bronchitis
progressive dypnoea
RHF (oedema, fatigue)
AF
Rosy cheeks and cyanosis

Question 19

Mitral Regurgitation Symptoms

Answer 19

Palpitations 
SOB
Fatigue 
RHF
Cachexia
displaced apex

Question 20

Tricuspid Regurgitation symptoms

Answer 20

RHF picture (due to increased R Atrial and systemic venous pressure)
Palpable pulsating liver
AF

Question 21

Pulmonary Stenosis symptoms

Answer 21

Sudden Death
R Hypertrophy and R HF
Fatigue syncope
Heave and thrill

Question 22

Causes Valvular Heat Disease

Answer 22

Vascular: IHD -> mitral and tricuspid regurgitation

Infective Endocarditis -> Aortic, Mitral and Tri Regurgitation

Tumours: Carcinoid -> mitral stenosis

Autoimmune/ Inflammatory: connective tissue diseases -> Mitral & Aortic R

Medication: Mitral Regurgitation

Inherited: Mitral, aortic and Pulmonary Stenosis + TR

CKD
Pagets
Degenerative changes