Malozzi-Valvular Heart Disease

Question 1

structure that holds heart valves in position

Answer 1

chordae tendinae

Question 2

3 cusps

Answer 2

semilunar valves

Question 3

2 leaflets

Answer 3

mitral valve

Question 4

3 leaflets

Answer 4

tricuspid valve

Question 5

to diagnose valvular heart disease

Answer 5

1. hx
2. auscultation
3. tests

Question 6

2 most important ways to diagnose valvular heart disease

Answer 6

auscultation
echo

Question 7

this type of murmur grows louder

Answer 7

crescendo murmur

Question 8

this type of murmur grows softer

Answer 8

decrescendo murmur

Question 9

this type of murmur first rises, then falls

Answer 9

crescendo-descrescendo murmur

Question 10

murmur that has same intensity throughout

Answer 10

plateau murmur

Question 11

valvular______leads to pressure overload

Answer 11

stenosis

Question 12

valvular _______ leads to volume overload

Answer 12

insufficiency/regurgitation

Question 13

valvular stenosis can ultimately lead to what

Answer 13

concentric hypertrophy/remodeling

Question 14

valvular insufficiency/regurgitation can ultimately lead to what

Answer 14

eccentric hypertrophy

Question 15

this valve pathology is due to age and congenital (bicuspid valve)

Answer 15

aortic stenosis

Question 16

what does the LV compensation to an obstruction in flow eventually lead to

Answer 16

concentric hypertrophy

Question 17

when LV can no longer compensate, what happens

Answer 17

eccentric hypertrophy and heart will fail

Question 18

3 main sx’s of progressive aortic stenosis

Answer 18

syncope
angina
dyspnea

Question 19

once symptoms develop for aortic stenosis, what is mortality rate

Answer 19

ave. survival up to 5 years

Question 20

how can you decipher severity of aortic stenosis murmur

Answer 20

the duration

Question 21

what is not a factor for severity of aortic stenosis

Answer 21

intensity of murmur

Question 22

more stenosis will eventually lead to _______ sounds

Answer 22

quieter

Question 23

Answer 23

calcifications on bicuspid aortic valve

Question 24

what do you need to think about with aortic stenosis if patient has symptoms

Answer 24

possible valve replacement

Question 25

what do you need to do to classify aortic stenosis in patient with no symptoms

Answer 25

look at velocity of blood flow across valve

Question 26

common causes of this include: structural defects stretching of aorta tertiary syphilis aortic dissection RHD (underdeveloped countries)

Answer 26

aortic regurgitation

Question 27

aortic regurgitation causes what three main things to increase

Answer 27

increased volume into LV increased preload increased afterload

Question 28

how is aortic regurgitation murmur best heard

Answer 28

at LUSB w/ patient leaning forward and listen after they have exhaled

Question 29

what to do if patient is symptomatic for aortic regurg

Answer 29

discuss valve replacement

Question 30

what to do if patient is asymptomatic for aortic regurg

Answer 30

check LVEF (if dropping means not able to compensate)

Question 31

this phase of mitral regurgitation causes sudden decrease in CO (cardiogenic shock)

Answer 31

Acute

Question 32

this phase of mitral regurgitation allows for compensation

Answer 32

chronic

Question 33

holosystolic murmur heard at apex of heart

Answer 33

mitral regurgitation

Question 34

to diagnose mitral regurgitation

Answer 34

CXR EKG Echo

Question 35

what will you find on CXR if patient has mitral regurg

Answer 35

cardiomegaly pulmonary edema

Question 36

what will you find on EKG if patient has mitral regurg

Answer 36

LA enlargement or Afib

Question 37

what to do if patient has primary Mitral regurg (no symptoms)

Answer 37

nothing

Question 38

what to do if patient has mitral regurg w/ symptoms and LV dysfunction

Answer 38

discuss valve replacement

Question 39

what to look at for any of these valve pathologies to decide whether to do surgery or not to replace them

Answer 39

LVEF

Question 40

Answer 40

mitral valve prolapse

Question 41

exaggerated billowing of mitral valve leaflets into atrium during systole

Answer 41

mitral valve prolapse

Question 42

mainly seen in young women; people who are tall and slender (Marfan's)

Answer 42

mitral valve prolapse

Question 43

most common cause is RF (uncommon in clinical practice today)

Answer 43

mitral valve stenosis

Question 44

diastolic murmur heard best at L lateral decubitus position at apex

Answer 44

mitral valve stenosis

Question 45

this valve pathology really doesn't have symptoms and is very common; heard at LLSB (systolic)

Answer 45

tricuspid regurgitation

Question 46

cause of tricuspid regurgitation

Answer 46

endocarditis (IV drug use)

Question 47

murmur increases with inspiration

Answer 47

Tricuspid regurgitation

Question 48

what to do in the case of severe tricuspid regurgitation

Answer 48

surgery; can remove valve

Question 49

2 main determining factors for valve replacement:

Answer 49

age if pt. can take anti-coagulants

Question 50

best type of valve replacement for people under age of 50

Answer 50

mechanical (metal); lasts a while

Question 51

best type of valve for older patients

Answer 51

bioprosthetic (doesnt last as long)

Question 52

to dx Rheumatic heart disease

Answer 52

2 major sx's or 1 major and 2 minor sx's

Question 53

Rx: Rheumatic heart disease

Answer 53

bed rest penicillin aspirin surgery