Aortic and Pulmonary Valve Disease Flashcards Preview

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Flashcards in Aortic and Pulmonary Valve Disease Deck (20):

Fusion of 2 of the cusps is called?



Systole vs Diastole in valves

Systole = open
Diastole = closed


Explain calcific vs Rheumatic disease of valves

Rheumatic - fuse first and then calcify
Calcific - calcifications first then fuses


Normally what happens to A2 and P2 when breathing? What happens with Aortic stenosis?

A2 before P2, with small separation upon inspiration.

With Stenosis, A2 comes after P2 upon inspiration


The more severe the stenosis, the ____ the murmur will peak

The later the murmur will peak


What happens when aortic stenosis occurs hemodynamically?

When the aortic valve is obstructed, your heart needs to work harder to pump blood to your body.
Extra work limits the amount of blood it can pump and may weaken your heart muscle.


Stages of stenosis

A: at risk of AS - aortic sclerosis, bicuspid valve
B Progressive AS - mild/moderate AS
C: Asymptomatic Severe AS
D: Symptomatic Severe AS


When the aortic valve is affected by rheumatic heart disease, what other valve is usually affected?



3 cardinal symptoms of stenosis:

1. Angina
2. Syncope
3. SOB


When is AVR indicated usually?

Valve replacement is recommended for individuals with symptomatic severe aortic stenosis. Such patients have a dire outlook, with 75% dying within 3 years of symptom onset


How is aortic stenosis diagnosed?

The echocardiogram with Doppler interrogation of the aortic valve serves as the mainstay of diagnosis


What is the main mechanism and when in life do you get AV stenosis

The tricuspid aortic valves become stenotic in the sixth, seventh, and eighth decades of life, mainly caused by calcium deposits in the valve cusps and not by fusion of the commissures


What is the most common congenital malformation of a valve? Who is most affected?

Bicuspid Aortic Valve; men affected 4:1, but only 1-2% of population have it


Signs of Aortic Regurgitation

Corrigan’s pulse: Rapid forceful carotid upstroke followed by rapid decline
Quincke’s pulse: Diastolic blanching in nail bed when slightly compressed
de Musset’s sign: Bobbing of head
Durozie’z sign: Systolic and diastolic femoral bruits when compressed with stethoscope
Hill’s sign: Systolic BP in legs > 30 mmHg than in arms


What's the preferred treatment of pulmonic stenosis right now? Who can't have it?

Percutaneous balloon valvuloplasty has largely replaced surgical valvotomy except in patients with dysplastic valves.


Aortic insufficiency (AI), also known as ________

aortic regurgitation (AR):
sws is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle.


aortic stenosis sounds

1. ejection click ( just precedes the murmur)
- opening snap
best heard at the lower left sternal border and the apex, and, thus, appear to be "split". The ejection sound, caused by the impact of left ventricular outflow against the partially fused aortic valve leaflets

2. S4


most common congenital cardiac defect

Bicuspid aortic valve disease


mainstay of diagnosis of aortic and pulmonic valve disease.

echocardiogram with Doppler interrogation

- Valve replacement is recommended for individuals with symptomatic severe aortic stenosis due to dire outlook, with 75% dying within 3 years of symptom onset.
- Have mechanical problem, need mechanical fix


If pt has severe aortic regurg (AR) and is symptomatic:
what is the treatment?

Get AVR (pretty straight forward)

note: If pt is asymptomatic and has LVEF>50% may monitor or get AVR.