Exam 4 Valvular Disease Flashcards

(56 cards)

1
Q

most common level of aortic stenosis

A

aortic valve - 75%, as opposed to sub or supravalvular

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2
Q

age 30 - 65 aortic valve concerns

A

congenitally bicuspid aortic valve becomes calcified/stenotic. congenital

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3
Q

Sx aortic stenosis

A

fatigue, exertional dyspnea

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4
Q

late Sx aortic stenosis

A

dyspnea, angina, syncope, heart failure

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5
Q

heart sound aortic stenosis

A

systolic ejection murmur, crescendo-decrescendo

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6
Q

physical exam sign aortic stenosis

A

thrill in suprasternal notch or 2nd right ICS

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7
Q

grade 1 murmur

A

barely audible

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8
Q

grade 2 murmur

A

quiet but clearly audible

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9
Q

grade 3 murmur

A

moderately loud

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10
Q

grade 4 murmur

A

loud, with thrill

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11
Q

grade 5 murmur

A

very loud, thrill, hear with steth partially off chest

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12
Q

grade 6 murmur

A

very loud, thrill, hear with steth completely off chest

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13
Q

lab finding aortic stenosis

A

left ventricular hypertrophy

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14
Q

porcelain aorta

A

calcium deposits on aorta, can be seen in CXR

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15
Q

Tx of symptomatic aortic stenosis

A

cardio referral, probably valve replacement

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16
Q

symptomatic aortic stenosis

A

angina, syncope, dyspnea/CHf

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17
Q

surface area a/w severe aortic stenosis

A

< 1.0 cm squared

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18
Q

hypertrophic cardiomyopathy cause

A

inherited 60%

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19
Q

hypertrophic cardiomyopathy murmur

A

same as aortic stenosis, louder when pt. stands, valsalva

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20
Q

Tx hyptertophic cardiomyopathy

A

calcium channel blockers, beta blocker

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21
Q

hypertrophic cardiomyopathy description

A

enlarged heart muscle without cause for secondary hypertrophy

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22
Q

aortic regurg description

A

blood leaks back through aortic valve during diastole

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23
Q

aortic regurg causes

A

aortic insufficiency

24
Q

physical exam signs aortic insufficiency/regurg

A

low diastolic, widened pulse pressure

25
aortic insufficiency/regurg requiring surgical intervention
ejection fraction <55%, symptomatic, asymptomatic with LV dilation, end systol 55mm, end diastolic 70mm
26
acute causes of aortic regurg
aortic dissection, surgical, endocarditis
27
progression of chronic aortic regurg
LV overload, dilation, hypertrophy, CHF, then <2 year survival
28
acute ar progression
pulmonary edema, doesn't compensate for overload
29
Tx aortic regurg
valve replacement
30
heart sound aortic regurg
austin flint murmur - low pitched diast murmur at apex
31
lab findings aortic regurg
left ventricular hypertrophy, sometimes CHF/pulmonary edema
32
Tx aortic regurg
ace inhibitors, vasodilators, valve replacement if symptomatic
33
mitral regurg definition
blood leaks from LV into LA
34
mitral valve structures involved in mitral regurg
leaflets, chordae tendineae, papullary muscles, annulus
35
causes of acute mitral regurg
papillary muscle necrosis, endocarditis
36
causes chronic mitral regurg
endocarditis, inherited, marfan's, rheumatic, etc
37
barlow syndrome
cause of mitral regurg, valve degen, a/w grave's disease, marfan's muscular dystrophy
38
a fib with mitral regurg
develops due to left atrial enlargement resulting from compensation
39
Sx mitral regurg
gradual appearance, dyspnea, fatigue, arrhythmias
40
heart sound mitral regurg
high pitched pansystolic murmur at apex
41
physical exam late mitral regurg
JVD, hepatomegaly, edema
42
lab findings mitral regurg
atrial enlargement, ventricular hypertrophies, a. fib.
43
Tx mitral regurg
ace inhibitors, vasodilators, Na reduction, diuretics, digitalis, valve repair or replacement
44
mitral valve prolapse description
during systole ballooning of mitral leaflets into left atrium
45
Tx mitral proplapse
most require none, if palp or arrhythmia beta blockers, if a/w regurgitation, use mitral regurg Tx
46
mitral stenosis description
narrowing mitral valve, increases LA pressure
47
cause of mitral stenosis
rheumatic heart disease most common
48
Sx mitral stenosis
dyspnea, pulmonary edema, pulmonary HTN, then right heart failure, a-fib, emboli
49
heart sound mitral stenosis
S1 opening snap then mid diastolic rumbling murmur
50
lab findings mitral stenosis
gigantic LA, smaller LV, right vent hypertrophy, a-fib, kerley B lines,
51
Tx mitral stenosis
mild: diuretics, Na restriction, warfarin a-fib embolus prevention, valve surgery
52
endocarditis description
vegetative growths on valve 2nd to bacterial infx
53
class 1 endocarditis requiring surgery
heart failure, pulmonary HTN, resistant organisms, heart block
54
class 2 endocarditis requiring surgery
recurrent emboli or vegetation in spite of abx
55
tricuspid regurg cause
right valve dysfunction a/w endocarditis
56
Tx endocarditis
abx