Cardio: Murmurs And Congenital Diseases Flashcards
(129 cards)
1
Q
2nd heart sound above aortic valve in case of aortic stenosis usually is
A
Weakend
2
Q
First heart sound at the heart apex is typical for
A
Mitral stenosis
3
Q
Facies covisart is typical of
A
Heart failure
4
Q
Apex beat is intensified due to
A
Left ventricular hypertrophy
5
Q
Epigastric pulsation can be caused by
A
1.pulsation of a.abdominalis,hepatic pulsation and pulsation of hypertrophic right ventricle
6
Q
Pulsation at the 2 Nd intercostal space originates fromright of the sternum
A
Aorta
7
Q
Apex beat displaced downwards and to left is typical for
A
Dilated left ventricle
8
Q
Apex beat displaced to left is typical for
A
Left ventricular hypertrophy
9
Q
Apex beat is not displaced to the left and downward in case of
A
Mitral stenosis
10
Q
Pulsus irregularis is
A
Irregular pulse wave
11
Q
Pulsus inequalis
A
Pulse of different amplitude in the artery
12
Q
Pulsus parodoxus is
A
Pulse disappears during inhalation
13
Q
Pulsus alterans is typical for
A
Heart failure
14
Q
Pulsus parodoxus is classified as
A
Pulse wave of normal amplitude interchy with waves of lower amplitude
15
Q
Pulsus filiformis is typical for
A
Bleeding and shock
16
Q
Pulsus celer et altus is typical for
A
Aortic regurgitation
17
Q
Pulse pressure is increased in the case of
A
Aortic regurgitation
18
Q
Auscultation point of Mitral valve is
A
5 th intercostal space ,1 cm medially from l.medioclavicularis sin
19
Q
Auscultation point of aortic valve are
A
2 Nd intercostal space to right of sternum and erbs point
20
Q
Auscultation point of pulmonary valve is
A
2 Nd intercostal space to left of sternum
21
Q
Aortic accentuation of 2 Nd sound is when
A
2 Nd sound of aorta is louder than second sound at truncus pulmonalis,indicates hypertension at large circuit
22
Q
Pulmonary accentuation of 2 Nd sound is when
A
2 Nd sound of truncus pulmonalis is louder than 1 st sound of truncus pulmonalis, indication of hypertension of small circuit
23
Q
S2 accentuation of the aorta is not typical for
A
Mitral stenosis
24
Q
Audible S3 in patients.aged 40 or older indicate
A
Ventricular systolic dysfn
25
S4 can be heard when
Ventricular myocardial diastolic dysfunction ( relaxation is disturbed)
26
Mesosystolic click is audible in case of
Mitral valve prolapse
27
Murmur at beginning of systole
Protosystolic
28
Murmur audible in the middle of systole
Mesosystolic
29
Murmur audible at the end of systole
Telesystolic
30
Murmur audible through systole
Holosystolic
31
Murmur audible in the beginning and middle of systole
Protomesosystolic
32
Murmur of gradually increasing pitch
Crescendo
33
Murmur of gradually decreasing pitch
Decrescendo
34
Murmur of pitch that increase at the beginning of heart cycle and then reduces is called
Crescendo decrescendo ( diamond shaped)
35
Murmur of constant pitch
Lentiform
36
Murmur audible in the middle of diastole
Mesodiastolic
37
Murmur audible at the beginning of diastole
Protodiastolic
38
Murmur audible at the end of diastole
Presystolic
39
Murmur throughout diastole is
Holodiastolic
40
Systolic murmur between scapulae is evidence of
Coarctation of aorta
41
Characteristics of levens murmur
Not palpable, audible in children, levens grade 1/6 to 3/6, audible during systole( mid systolic),best heard at the apex or lower left sternal border
42
Crescendo cardiac murmur
Incresases
43
Decrescendo cardiac murmur
Decreases
44
Lentiform cardiac murmur is of
Constant amplitude
45
Mitral valve prolapse is described by
Late systolic murmur at the apex and mesosystolic click at the apex
46
Systolic murmur at the apex beat is typical for
Mitral regurgitation
47
Which valvular heart disease cause early congestion in lungs
Mitral stenosis
48
Direct signs of Mitral stenosis
Presystolic murmur, diastolic murmur,mitral valve opening snap,echo mitral stenosis aign
49
Is left atrial enlargement direct sign of Mitral stenosis
No,it is secondary sign
50
Rheumatism can damage which heart layers
All heart wall layers
51
Which heart disorder has the triad of symptoms angina, syncope ( fainting) and dyspnoea ( shortness of breath)
Aortic stenosis
52
What should we use to confirm the diagnosis of mitral valve prolapse ?
Echocardiography
53
Dizziness and scope are typically for
Aortic stenosis
54
Angina is a typical symptom of
Aortic stenosis
55
Increased pulse pressure amplitude is typical for
Aortic regurgitation
56
Which examination method is used to diagnose mitral stenosis
Echocardiography
57
Diastolic murmur at 3 rd or 4 th intercostal space left from sternum is characteristics for
Aortic regurgitation
58
Normal systolic pressure at a
Pulmonalis at rest
15 to 25
59
Typical symptoms of aortic regurgitation
Left ventricular enlargement,high amplitude pulse pressure, diastolic murmur over aortic valve ,visible aortic pulsation in supraventricular areas,visible capillary pulse, early diastolic murmur,heart sound above arterial blood vessels,pulsus celer et altus
60
61
Lower extremity thromboembolism is common complications of
Mitral stenosis of left atrium,left heart valve bacterial endocarditis, atherosclerosis in aorta
62
Mitral valve prolapse is often manifested by
Late systolic murmur, atypical chest pain and palpitations, rhythm and repolarization phase ECG changes, easily identifiable echo,benign finding
63
The serious complications of mitral valve prolapse are
Infectious endocarditis, paroxysmal SVT, syncope, ischemic ecg
64
Is third degree av block a serious complications of mitral valve prolapse
No
65
Basic concept that distinguish mitral and aortic valve disease, mechanism and pathogenesis is that
Mitral valve is an endocardial structure,the aortic valve is arterial structure
66
Clubbing fingers are Typical for
Congenital valvular diseases
67
Marked pulsation of a.carotis is typical for patients with
Aortic regurgitation
68
Pupil pulsation is typical for
Aortic regurgitation
69
Hepatic pulsation and ventricularization of venous pulse are caused by
Tricuspid regurgitation
70
Which is not characteristics of mitral stenosis : acrocyanosis, redness of cheeks,apex beat displaced downwards and left, epigastric pulsation
Apex beat displaced to downward and left
71
Dysphagia in mitral stenosis is due to
Oesophagus suppression due to enlarged left atrium
72
Clinical feature ( manifestation) of mitral regurgitation is
Late manifestation
73
Ausculative pattern in case of mitral regurgitation is
Soft s1, systolic murmur
74
Aortic stenosis can cause
Skin paleness
75
Aortic regurgitation signs
Carotid dance,Musset symptom, dilation of left ventricle,dirojes double sound, increased pulse pressure , diastolic
76
Diastolic murmur of aortic regurgitation is best audible when patient is
Sitting leaning forward
77
Diastolic murmur of Mitral stenosis is best audible when
Patient exhales lying in left lateral decubitus position
78
Systolic click of mitral valve prolapse is best audible when a patient is
Standing
79
Classic symptoms triad for pat with aortic stenos
Syncope,Angina, Dyspnoea
80
Is anticoagulants indicated for pat after implantation of biological prosthetic valve
No, Anticoagulants is not indicated if other indications doesn't exist
81
Symptoms of tricuspid valve regurgitation
Peripheral edema,ascites, hepatomegaly
82
Hemoptysis is seen in
Mitral stenosis
83
The area of mitral valve orifice in mitral stenosis is non compatible with life is
Less than 0.5 cm square
84
In rheumatic heart disease,most common cause of embolism is
Mitral stenosis with atrial fibrillation
85
Valve area associated with dev of clinical symptom of Mitral stenosis is
Less than 2.5 cm square
86
What is absent in mitral stenosis :
Opening snap,middiastolic murmur, S3 and right ventricular enlargement
S3
87
The earliest ECG signs of Mitral stenosis is
Left atrial enlargement
88
Acute severe aortic regurgitation is characterized by all except: increased ejection fraction, increased HR, increased peripheral vascular resistance, increase left ventricular end diastolic pressure
Increased ejection fraction
89
Which hemodynamic component decrease during exercise in severe mitral stenosis
Cardiac output
90
Most common arrythmia in mitral stenosis is
Atrial fibrillation
91
Which heart is normal in mitral stenosis
Left ventricle
92
Which valve is mostly affected by calcification
Aortic
93
Where doesn't embolism occur with theombinfrom left atrium: brain, kidney,liver, spleen
Liver
94
Which valve is rarely calcified
Pulmonary
95
Normal aortic valve orifice size is
3 to 4 cm2
96
Syncope is more characteristics of
Aortic stenosis
97
Right ventricular hypertrophy is characteristics of
Mitral stenosis
98
Gold standard for treatment in patients with severe aortic stenosis
Surgical valve implantation
99
Which one is the rarest cause of tricuspid regurgitation in developed countries
Rheumatic heart disease
100
Which is the most common valvular pathology secondary to left ventricular remodeling
Secondary mitral regurgitation
101
Secondary Mitral regurgitation is
Leakage of blood through mitral valve due to remodelling of left ventricle
102
Causes of pulmonary edema
Mitral regurgitation and stenosis,aortic regurgitation
103
Does tricuspid regurgitation cause pulmonary edema
No
104
Characteristics of mitral stenosis
Impaired left ventricular filling
105
Characteristics of aortic valve insufficiency ( regurgitation)
Diastolic murmur in second intercostal space right to sternum
106
Mean pressure gradient for moderate mitral stenosis
5 to 10 mm Hg
107
Mean pressure gradient between left atrium and left ventricle is 11 mmHg, what is diagnosis
Severe mitral stenosis
108
Incomplete mitral valve closure due to left chamber dilation is
Secondary ( functional) mitral regurgitation
109
Pressure like chest pain provoked by physical activity is typical for
Coronary artery stenosis and mitral stenosis
110
ECG ,SV1 + RV5 =10mm is typical for
Aortic stenosis and regurgitation,left chamber hypertrophy
111
Deviation of apical impulse to left is typical for
Aortic regurgitation and mitral regurgitation
112
Systolic murmur,heard at 2nd intercostal right of sternum, dyspnoea and retrosternal chest pain, family history of Valve patho,ECG:LVH
Diagnosis
A bicuspid aortic valve with severe stenosis
113
82 year old, progressive Dyspnoea on minimal exertion,head spinning upon getting up,BP:155/90,used antihypertensive for 20 years,Renal disease stage 4,GFR25ml/min, systolic murmur on all auscultation site . Diagnosis
Severe aortic stenosis due to degenerative aortic valve disease
114
Dyspnoea, heaviness in chest and right border, increase in weight by 6kg, cyanosis of lips,BP210/70mmHgHR:80,audible noise to left of sternum,4 th ICS, hepatomegaly,edema of legs,ascites
Diagnoy
Tricuspid regurgitation
115
Most common valvular diseases encountered among adults today
Mitral regurgitation and aortic valve stenosis
116
Valvular heart disease with highest risk of systemic thromboembolism is
Mitral stenosis
117
Echo parameters of severe aortic stenosis
Surface area less than 1 cm2, average pressure gradient more than 40 mmHg
118
In pat.with mitral stenosis, echo finding will be
Left atrial enlargement,right atrial and ventricular enlargement
119
In mitral insufficiency/regurgitation,echo finding are
Left atrial and left ventricular enlargement
120
In pat with aortic stenosis, common echo finding qre
Left atrial and left ventricular enlargement
121
In adult pat with atrial septal defect, common echo finding are
Left and right atrial enlargement
122
Etiologies of native valve aortic regurgitation are
Congenital heart disease,rhematic fever,infective endocarditis,valve degeneration
123
Etiologies of Mitral valve stenosis are
Congenital heart disease, rhematic fever, infective endocarditis and valve degeneration
124
Etiologies of native mitral regurgitation
Myocardial/ chordal rupture, congenital heart disease, rhematic fever, infective endocarditis,valve degeneration,left ventricular/ atrial remodelling
125
Common complications of. Congenital and aquired heart disease in adults
Arrhythmia, chronic heart failure, sudden cardiac deaths,infective endocarditis
126
127
Interventional treatment options for aortic stenosis
Surgical valve replacement with mechanical or bio prosthetic valve,transaortic/apical valve implantation (TAVI), balloon valvuloplasty
128
Interventional treatment options for pat with mitral stenosis
Surgical valve replacement therapy with mechanical or bio prosthetic valve, balloon valvuloplasty, percutaneous mitral commissurotomy
129
Interventional treatment options for pat with mitral regurgitation
Surgical valve replacement with mechanical or bio prosthetic valve,annuloplasty, percutaneous edge to edge procedures
