murmurs and valve disease Flashcards
(15 cards)
what is aortic regurgitation
leaking of the aortic valve causing blood to flow in reverse direction during ventricular diastole
features of aortic regurgitation
early diastolic murmur
collapsing pulse
wide pulse pressure
de musset’s sign (head bobbing)
mid-diastolic austin-flint murmur in severe AR
investigation for AR
echocardiography
management of AR
medical management of any associated heart failure
surgery indications: symptomatic patients with severe AR, asymptomatic patients with severe AR who have LV systolic dysfunction
ejection systolic murmur louder on expiration
aortic stenosis
HOCM
ejection systolic murmur louder on inspiration
pulmonary stenosis
atrial septal defect
pansystolic murmur
mitral//tricuspid regurgitation (high pitched and blowing)
- tricuspid louder on inspiration
ventricular septal defect (harsh in character)
late systolic murmur
mitral valve prolapse
coarctation of the aorta
early diastolic murmur
aortic regurgitation (high pitched and blowing)
graham- steel murmur- pulmonary regurg
mid-late diastolic
mitral stenosis
austin flint- severe aortic regurgitation- rumbling
pansystolic murmur in IV drug user
tricuspid valve endocarditis
mid diastolic murmur at the apex
mitral stenosis
- most common cause rheumatic heart disease
features of mitral stenosis
dyspnoea (pulmonary venous hypertension)
haemoptysis
mid-late diastolic murmur
loud S1
opening snap
low volume pulse
malar flush
AF
features of severe mitral stenosis
length of murmur increases
opening snap become closer to S2
management of mitral stenosis
patients with associated AF: anticoag (warfarin)
asymptomatic patients: monitor with regular echos
symptomatic patients: percutaneous mitral balloon valvotomy, mitral valve surgery (commissurotomy or valve replacement)
