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2nd Semester Final > Valvular Heart Disease Lecture Powerpoint > Flashcards

Valvular Heart Disease Lecture Powerpoint Flashcards

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1
Q

Imaging study of choice for most valvular diseases

A

-Echocardiogram

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2
Q

Primary symptom of most valvular diseases regardless of whether its insufficiency or stenosis, mitral or aortic

A

Dyspnea

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3
Q

Left vs right cusps and corresponding coronary artery

A

Left cusp is over the left atrium and guards the left main coronary artery
Right cusp is over the right ventricle and guards the right coronary artery

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4
Q

Most common structural anatomic congenital disease in patients

A

VSD

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5
Q

Most common valvular anatomical congenital disease in patients

A

Bicuspid aortic valve

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6
Q

Bicuspid aortic valves are associated with these conditions (3)

A
  • cystic medial degeneration (tunica media degenerates and forms aneurysm)
  • aneurysmal dilation of ascending aorta
  • subvalvular and supravalvular aortic stenosis (rare)
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7
Q

Rating of stenotic valves (4)

A

Mild, moderate, severe, or critical

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8
Q

3 symptoms of aortic stenosis

A

-syncope
-angina (coronary steal syndrome, blood not coming back during diastole)
-dyspnea
(SAD)

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9
Q

Most common cause of acquired aortic stenosis

A

Senile degenerative calcification (most common with age)

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10
Q

Dobutamine stress testing and pseudo AS

A

When undergoing testing with dobutamine does not see increase in gradient difference, indicating failure of muscle rather than valve problem

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11
Q

Unless symptomatic, ____ is not recommended for treatment of AS because…

A

heart surgery

…if asymptomatic, no increase in life expectancy by doing so

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12
Q

Acquired Aortic Stenosis prognosis and treatment (3)

A

-good until symptoms develop (then 3 year mortality is 50%)

-Treatment is artificial valve replacement (bioprosthetic or mechanical) or TAVR
or balloon valvuloplasty in extreme cases

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13
Q

Acquired aortic insufficiency causes (3)

A
  • senile degenerative calcification
  • systemic hypertension
  • idiopathic annuloaorticectasia (no known cause)
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14
Q

Acquired aortic insufficiency symptoms (3)

A
  • dyspnea on exertion
  • orthopnea
  • CHF
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15
Q

Aortic insufficiency can sequallae into…

A

….LV dilation from diastolic overload

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16
Q

Mussett’s sign

A

Slight head bobbing rare but occasionally seen in end stage valvular diseases

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17
Q

Acquired aortic insufficiency prognosis and treatment (3)

A
  • poor with progression of signs and symptoms or CHF

- Vasodilator therapy, afterload reduction with diuretics, or AVR surgery

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18
Q

Aortic insufficiency is not a pressure dysfunction, but rather a…

A

….volume overload

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19
Q

Chordae tendinae

A

attached to papillary muscles in the left ventricle and the mitral valve that pull the valve open and let it shut during ventricular filling and emptying

20
Q

Myxomatous mitral valve disease

A

Inherited mitral valve prolapse

21
Q

Mitral valve stenosis etiologies (2)

A
  • rheumatic carditis

- degenerative calcification

22
Q

Anything that causes increased pressure in the left atrium can result in…

A

…atrial fib

23
Q

Mitral valve stenosis symptoms

A
  • palpitations

- dyspnea on exertion

24
Q

Classic triad of signs for mitral stenosis

A
  • right bundle branch block
  • right axis deviation
  • biatrial enlargement
25
Q

Mitral valve stenosis treatment of choice

A

balloon valvuloplasty

26
Q

1st vs 2nd acquired mitral regurgitation

A

primary - problem with valve itself

secondary - due to a separate cardiomyopathy

27
Q

Mitral valve regurgitation symptoms (3)

A
  • dyspnea upon exertion
  • fatigue
  • CHF
28
Q

Mitral regurgitation physical exam findings (3)

A
  • holosystolic murmur (heard everywhere)
  • S1 and S2 obliterated
  • PMI laterally displaced
29
Q

Acquired mitral regurgitation prognosis and treatment (3)

A
  • prognosis is VERY poor when signs develop

- afterload reduction pharmacological drugs, surgical repair of mitral valve or replacement

30
Q

Golden moment for mitral valve regurgitation

A

Determines if it is time to undergo surgery if 2/5 criteria are met

31
Q

Aortic valve disease ___, mitral valve disease ___ because ____

A

replace, repair, chordae tendinae preservation

32
Q

Epstein anomaly

A

Congenital defect where tricuspid valve is displaced apically otward bottom of right ventricle so right atrial becomes significantly larger, often associated with ASD

33
Q

Primary acquired defects in tricuspid valve disease

A
  • infective endocarditis
  • rheumatic
  • trauma
34
Q

2ndary acquired defects in tricuspid valve disease

A
  • primary right ventricle disease

- left to right shunt (eisenmenger - irreversible)

35
Q

Tricuspid regurgitation physical findings(3)

A
  • ascites
  • JVD
  • peripheral cyanosis
36
Q

Tricuspid treatment

A
  • Surgical

- TVR only if not possible

37
Q

Tetralogy of Fallot

A

-VSD that overrides the aorta resulting in pulmonary valve narrowing and thickening of the right ventricle**

38
Q

Right sided endocarditis most often involves the ____ valve, very rarely the ___ valve

A

Tricuspid, pulmonic

39
Q

Greater the pressure gradient between ventricle and aorta correlates ____ to the level of stenosis of the aortic valve

A

directly

40
Q

Normal S1 but diminished S2 indicates….

A

Aortic stenosis, the valve is not slamming shut as it should during diastole

41
Q

Aortic sclerosis murmur

A

Creates a systolic murmur due to valve hardening and not opening completely

42
Q

Aortic insufficiency murmur

A

Creates a diastolic murmur due to backflow of blood

43
Q

Aortic insufficiency first line of treatment

A

-ACE or ARB

44
Q

Rheumatic fever most often affects this valve

A

Mitral

45
Q

2 out of 5 of these indications require surgical intervention for mitral regurgitation (Golden moment)

A
  • LV output <55%
  • Ventricular dilation at end systole
  • Pulmonary hypertension
  • Afib
  • symptomatic

2nd Semester Final (207 decks)

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