Dr. John's Week 4 Flashcards
(30 cards)
Mitral Stenosis: high or low pitch?
low pitch
Where is mitral stenosis heard best?
lying on left side; at apex
Cause of mitral stenosis?
rheumatic, rarely congenital
Aortic Stenosis heard when and where?
early to mid-systolic best over the base
Where is diastolic mitral stenosis best heard?
diastolic murmur heard best at apex with patient in left lateral recumbent position
What is the sound of aortic insufficiency?
high pitched diastolic murmur heard best at base
Cause of aortic insufficiency?
two thirds are rheumatic endocarditis, trauma, congenital
Describe an aortic insufficiency murmur
louder and longer with increasing severity, ‘water hammer’ pulse, increased pulse pressure; best heard at base
What is the pathophysiology of aortic insufficiency?
increased stroke volume
Deterioration of what in aortic insufficiency precedes symptoms?
left ventricular function
Symptoms of aortic insufficiency?
uncomfortable awareness of heartbeat when lying down, exertional dyspenea first symptom followed followed by orthopnea and PND, angina, CHF
When do you hear Mitral Valve Prolapse?
mid or late systolic
What is the old name for Mitral Valve Prolapse? Where is it hear?
click-murmur syndrome; heard best at the apex
What may follow a mitral valve prolapse murmur?
a high pitched late systolic murmur
What is the cause of mitral valve prolapse?
congenital or genetic, very common, females between ages 14 and 30
What is the pathophysiology of mitral valve prolapse?
myxomatous degeneration of posterior leaflet
Are mitral valve prolapse benign or a trigger?
benign but may trigger arrhythmias
What is the tx for mitral valve prolapse?
reassurance
What are the two right sided murmurs?
tricuspid stenosis and tricuspid regurgitation
Where do you see tricuspid stenosis?
rare in developed countries; rheumatic
What is tricuspid stenosis associated with?
mitral stenosis
dyspnea
abnormally uncomfortable awareness of breathing; can relate to exertion of not
Differential Dyspnea on Exertion
CHF, angina (anginal equivalent), obstructive airway ds, anemia, hypothyroid, metabolic acidosis (DKA), anxiety and hyperventilation
Dyspnea causes not related to exertion?
sudden episodes at rest: PE, pneumothorax, anxiety
