Valve Disease Flashcards

1
Q

Name the two systolic murmurs

A

Mitral Regurgitation

Aortic Stenosis

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2
Q

Name the two diastolic murmurs

A

Mitral Stenosis

Aortic Regurgitation

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3
Q

What are the most common causes of Mitral Stenosis?

A
  • Rheumatic Heart disease, secondary to rheumatic fever

- could also be congenital or arthritic

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4
Q

How much is the valve narrowed in stenosis?

A

From 4-6cm to <2cm

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5
Q

Consequences of Aortic Stenosis?

A

Increased pressure in Left atrium

  • increased pressure in pulmonary veins
  • tricuspid and pulmonary valve become incompetent under pressure.
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6
Q

What two factors affect the severity?

A
Flow rate (dependent on CO, HR)
Pressure Gradient
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7
Q

SIGNS of MS

A
dyspnoea
stroke
Haemoptosis
chest pain
infective endocarditis
hoarse voice
mitral facies
JVP- prominent a wave
tapping apex beat
diastolic thrill
RV heave
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8
Q

Investigations for MS

A

ECG catheterisation
CXR
Echo- ** best for looking at leaflets.
Cardiac MRI

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9
Q

Treatment for ms

A

meds- diuretics, control AF, anticoagulation

Surgery- valve replacement or valvotomy

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10
Q

Mitral Regurgitation- causes

A

Rheumatic Heart Disease
Mitral Valve prolapse
Degenerative
change in LV- hypertrophy

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11
Q

MR- consequences?

A

Chronic- LV will compensate

Acute- LV doesn’t have a chance to compensate- v bad

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12
Q

SIGNS OF MR

A

Acute- SOB, Pulmonary Oedema, Cardiogenic Shock
Chronic- Fatigue, exhaustion, RH failure, dyspnoea, palpitations
Loud systolic murmur
Hyper dynamic Apex Beat
JVP- elevated in Heart failure`

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13
Q

Investigation in MR

A

ECG- tall p wave
CXR- oedema
Echo- look at valve **

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14
Q

Treatment of MR

A

Medical- reduce afterload and preload in acute= diuretics.

Surgery- replace or repair.

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15
Q

Aortic Valve Stenosis causes

A

Degenerative- due to high stresses on aortic valve

Congenital - bicuspid aortic valve

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16
Q

Consequences of AS

A

High LV systolic pressure
LVH
High ED pressure
High O2 demand= more susceptible to ischaemia.

17
Q

SIGNS of AS

A
Long period will be asymptomatic
Symptoms = bad
Chest Pain
Syncope
SOB on exertion
Heart Failure
Pulse- small and slow rising
JVP- prominent in Heart failure
Vigorous and hyper dynamic apex beat
harsh systolic murmur- carotid
18
Q

Investigations for AS

A

ECG- tall r wave
CXR- calcification if valve
ECHO- look at valve and LV function

19
Q

Treatment of AS

A
  • Only for those with heart failure

- Valve replacement

20
Q

Aortic Regurgitation- causes?

A

Dilated Aorta
Bicuspid Aortic Valve
Connective Tissue Disorder- Marfans

21
Q

Consequences of AR

A

High EDV and Stroke Volume

Hypertrophy and Dilation= increased demand for O2= MI= Heart Failure

22
Q

Clinical signs of AR

A
Chronic- long asymptomatic phase
Acute- pulse, large and collapsing
quiet diastolic murmur
wide pulse pressure
hyper dynamic misplaced apex beat.
23
Q

Investigations of AR

A

ECG
CXR
ECHO-

24
Q

Treatment of AR

A

Medical - vasodilators - delay surgery for 2-3 years.

Surgery - replacement or repair