Cardiac diseases + valves

Question 1

Mitral regurg causes

Answer 1

Functional, annular calcification, rheumatic fever, IE
Mitral valve prolapse, ruptured chordae tendinae
Cardiomyopathy, connective tissue disorders
Appetite suppressants

Question 2

Symptoms of Mitral regurg

Answer 2

Dyspnoea
Fatigue
Palpitations
Symptoms of causative factor

Question 3

Signs of Mitral regurg

Answer 3

AF
Displaced, hyperdynamic apex
Pansystolic murmur at apex radiating to the axilla

Question 4

Management of mitral regurg

Answer 4

Rate control
  B-blocker or rate limiting Ca blocker
  Add digoxin
  Then consider amiodarone
  Do not give b-blockers with verapamil
Anticoagulate
Prosthetic valve
Diuretics to improve symptoms

Question 5

Mitral valve prolapse causes

Answer 5

Very common
Alone
ASD, patent ductus arteriosus
Cardiomyopathy
Turner’s syndrome / Marfan’s
Osteogenesis imperfecta
WPW

Question 6

Treatment for mitral valve prolapse

Answer 6

Beta-blockers help palpitations and chest pain

Surgery if severe

Question 7

Causes of Mitral stenosis

Answer 7

Rheumatic fever, congenital
Mucopolysaccharidoses
Prosthetic valve
Malignant carcinoid

Question 8

Signs of Mitral stenosis

Answer 8

Malar flush
Tapping, non-displaced apex beat
Fatigue, palpitations
Chest pain
Systemic emboli
IE

Question 9

Sounds of Mitral stenosis

Answer 9

Loud S1
Opening snap
Rumblish mid-diastolic murmur heard on expiration

Question 10

Sounds of Mitral valve prolapse

Answer 10

Mid-systolic click or late systolic murmur

Question 11

Sounds of mitral regurg

Answer 11

Pansystolic murmur at apex
Soft S1
Split S1
Loud P2

Question 12

Sounds of aortic stenosis

Answer 12

Aortic thrill

Ejection systolic murmur

Question 13

Sounds of Aortic sclerosis

Answer 13

Ejection systolic murmur

Question 14

Sounds of aortic regurgitation

Answer 14

High pitched early diastolic murmur

Quincke’s sign

Question 15

Causes of Aortic stenosis

Answer 15

Senile calcification, rheumatic heart disease

Question 16

Causes of aortic sclerosis

Answer 16

Senile degeneration of the valve

Question 17

Causes of acute Aortic regurg

Answer 17

IE
Ascending aortic dssection
Chest trauma

Question 18

Causes of chronic aortic regurg

Answer 18

Congenital, connective tissue disorder
Takayasu arteritis, rheumatoid, SLE
HT

Question 19

Sounds of tricuspid regurg

Answer 19

Pansystolic murmur

Question 20

Sounds of tricuspid stenosis

Answer 20

Open snap + early diastolic murmur at left sternal edge

Question 21

Sounds of pulmonary stenosis

Answer 21

Ejection click, ejection systolic murmur

Question 22

Sounds of pulmonary regurg

Answer 22

Decrescendo mumur in early diastole

Question 23

Causes of tricuspid regurg

Answer 23

Functional, rheumatic fever, IE

Question 24

Causes of tricuspid stenosis

Answer 24

Rheumatic fever

Question 25

Causes of pulmonary stenosis

Answer 25

Congenital | Rheumatic fever, carcinoid

Question 26

Causes of Pulmonary regurg

Answer 26

Pulmonary HT

Question 27

Symptoms and signs of Acute myocarditis

Answer 27

HF symptoms Palpitations Tachycardia Soft S1

Question 28

Causes of Acute myocarditis

Answer 28

``` Idiopathic Viral Bacterial Spirochaetes Protozoa Drugs Toxins Immunological ```

Question 29

Symptoms of Dilated cardiomyopathy

Answer 29

Fatigue, dyspnoea Pulmonary oedema, RVF Emboli

Question 30

Signs of Dilated cardiomyopathy

Answer 30

``` Inc pulse Dec BP Inc JVP Pleural effusion, Oedema, Ascitis Jaundice, Hepatomegaly ```

Question 31

Treatment for Dilated cardiomyopathy

Answer 31

Bed rest ACE-I, B-blockers, diuretics Anticoagulation Biventricular pacing, ICDs, LVADs, Transplantation

Question 32

Symptoms and Signs of Hypertrophic cardiomyopathy

Answer 32

Sudden death, angina Dyspnoea, palpitation, syncope CCF

Question 33

Treatment for Hypertrophic cardiomyopathy

Answer 33

Amiodarone, B-blockers | Anticoagulate

Question 34

Causes of Restrictive cardiomyopathy

Answer 34

Idiopathic, amyloidosis | Haemochromatosis, sarcoidosis

Question 35

Treatment for restrictive endocarditis

Answer 35

Treat the cause

Question 36

Causes for Acute pericarditis

Answer 36

Viruses, bacteria, fungi + parasitic, autoimmune, drugs, metabolic Others: trauma, surgery, radiotherapy, MI, malignancy, CHF

Question 37

Treatment for Acute pericarditis

Answer 37

NSAIDs or aspirin with gastric protection | Add colchicine to reduce risk of recurrence

Question 38

Causes of Pericardial effusion

Answer 38

Pericarditis, myocardial rupture, aortic dissection

Question 39

Clinical ft of Pericardial effusion

Answer 39

Dyspnoea, chest pain Local structures being compressed: hiccoughs (phrenic nerve), nausea (diagphragm), bronchial breathing at left base (left lower lobe)

Question 40

Management of Pericardial effusion

Answer 40

Pericardiocentesis

Question 41

Causes of constrictive pericarditis

Answer 41

Unknown, TB, after pericarditis

Question 42

Management of Constrictive pericarditis

Answer 42

Surgical excision

Question 43

Signs of cardiac tamponade

Answer 43

Increase pulse Dec BP Pulsus paradoxus Inc JVP

Question 44

Diagnosis of Cardiac tamponade

Answer 44

Beck’s triad Dec BP Inc JVP Muffled heart sounds

Question 45

Management of Cardiac tamponade

Answer 45

Pericardial effusion for drainage Send for culture, ZN stain/TB culture Cytology