Cardiology differentials: valve lesions and murmurs

Question 1

Differentials for ESM?

Answer 1

Aortic stenosis
Pulmonary stenosis
Aortic sclerosis
HOCM
ASD

Question 2

Differentials for pansystolic murmur?

Answer 2

Mitral regurgitation
Tricuspid regurgitation
VSD
ASD

Question 3

Differentials for a diastolic murmur?

Answer 3

Aortic regurgitation
Pulmonary regurgitation
Mitral stenosis
Tricuspid stenosis

Question 4

Causes of aortic stenosis?

Answer 4

Calcific degeneration (most common)
Congenital bicuspid valve
Post-rheumatic fever
IE
Hyperuricaemia
Paget’s disease

Question 5

Causes of mitral regurgitation?

Answer 5

Acute: IE, rupture of chordae tendineae, trauma

Chronic: IE, connective tissue disorders, mitral valve prolapse, RA/SLE (Libman-Sacks endocarditis)

Question 6

Causes of aortic regurgitation?

Answer 6

Acute: IE, aortic dissection, rheumatic fever, ruptured sinus of vasalva

Chronic: bicuspid aortic valve, Marfan’s, rheumatic fever, IE, syphilis, ankylosing spondylitis

Question 7

Causes of mitral stenosis?

Answer 7

Rheumatic fever (v common, 90%)
Annular calcification
Congenital
Left atrial myxoma

Question 8

Causes of VSD?

Answer 8

Congenital
Post-MI (24-72h)

Question 9

Causes of ASD?

Answer 9

Congenital (Downs’, Klinefelter’s, Noonan’s + MVP)

Question 10

Coarctation of the aorta associations? cardiac and non-cardiac

Answer 10

Cardiac: bicuspid aortic valve, PDA, VSD, aortic dissection

Non-cardiac: Turner’s syndrome, Berry aneurysm, NF type 1, Marfan’s syndrome

Question 11

Associations with mitral valve prolapse?

Answer 11

Cardiomyopathy
WPW syndrome
PDA
Marfan’s syndrome
Muscular dystrophies

Question 12

Causes of tricuspid stenosis?

Answer 12

Carcinoid syndrome
Congenital (partial tricuspid atresia)
Rheumatic fever