Flashcards in Pulmonic, Tricuspid, Prosthetic valves Deck (40):
Vmax and peak instantaneous gradient associated with severe PS
PIG> 64 mmHg
Are mild and moderate PR "normal variants?"
3 causes of severe PR
In severe PR, where color jet fills RVOT, what will the CW deceleration slope look like?
Steep (may end abruptly)
Most common etiology of Tricuspid Stenosis
JVP in TS
Giant a- wave
Diminished y descent
What vena contracta is considered severe for all valvular regurge?
What stage is severe, asxs TR (VC>.7cm, hepatic vein systolic flow reversal)?
What stage is severe sxs TR (vena contracta>.7cm, hepatic vein systolic reversal)?
What do CW jet density and contour look like in severe TR?
Triangular with early peak
When is TV repair a class I indication for severe TR?
At time of left sided valve Sx
Is pressure half time in severe MS long or short?
Is pressure half time in severe AI long or short?1
Sxs: flushing, diarrhea, wheezing. Dx? What percent of pt's develop cardiac involvement?
Test for carcinoid
24h urine 5-HIAA
What valve lesion commonly occurs with carcinoid?
Migraine Rx similar to carcinoid except causes more left sided valve lesions
What left sidd lesions do radiation and antiphospholipid Ab syndromes usually cause?
What bug requires only a single Cx to be considered a major criteria for endocarditis?
3 echo findings,besides veg, that count as major criteria for endocarditis
New partial prosthetic valve dehiscence
Typical organisms causing endocarditis
Strep G, A, C
Which resistant organisms require early surgery for endocarditis?
What is considered a large vegetation on echo?
Name 4 reasons in endocarditis to do early Sx
Valve dysfxn/LV dysfxn
Resistant org (s. aureus, fungi)
Heart block/ abscess
Abx regimen for endocarditis ppx
(Cephalosporins or clinda if allergy)
Under age 60, what type of prosthetic valve is recommended?
After age 70, what type of prosthetic valve is recommended?
If you detect regurgitation of a prosthetic valve, how often do you do followup echoes?
q 3-6 mo's
What are 3 risk factors for thrombosis of prosthetic valve?
previous thromboembolic event
All patients with a prosthetic valve (bio or mech) should get what med?
What anticoagulatuon or ASA do you do for a patient with a bio prosthetic valve and 1 risk factor?
What is INR goal for mech AVR and no risk factors?
What do you do if patient has a thromboembolic event with prosthetic valve when INR was 2.5-3.5?
Inc goal to 3.5-4.5
Which type of prosthetic valve does not require heparin or lovenox bridge for Sx?
Who usually gets patient-prosthesis mismatch?
Older women (LOL)
Which type of prosthetic valve is at greatest risk for thrombosis?
Which prosthetic valves do better with thrombolytics?
Right sided valves
According to prosthetic valve thrombosis guidelines, when is it ok to give fibrinolytics?
Recent onset , NYHA class I-II sxs, small thrombus <.8cm
FAILED heparin gtt
What prosthetic valve is at greatest risk of endocarditis?