Valve Disease

Question 1

What is a cardiac murmur?

Answer 1

Noise due to turbulent blood flow within the heart

Question 2

Diastolic murmurs are in time with the carotid pulse. True/False?

Answer 2

False

Systolic murmurs are in time with the carotid pulse

Question 3

What are the 5 steps for describing murmurs?

Answer 3

Systole or diastole?
Which type of murmur?
Where is it best heard?
Does it radiate?
What is the grade?

Question 4

Where do aortic murmurs tend (but not always) radiate to?

Answer 4

Carotids

Question 5

Where do mitral murmurs tend (but not always) radiate to?

Answer 5

Axilla

Question 6

Where do tricuspid murmurs tend to radiate?

Answer 6

Nowhere!

Question 7

What is a thrill?

Answer 7

Palpable murmur

Question 8

What is a heave?

Answer 8

Palpable sensation due to ventricular stress/hypertrophy

Question 9

Which murmurs, left or right sided, are louder on inspiration?

Answer 9

Right sided

Question 10

Name the main non-invasive investigation for diagnosing cardiac murmurs

Answer 10

Echocardiography

Question 11

Name an invasive investigation for diagnosing cardiac murmurs

Answer 11

Cardiac catheterisation

Question 12

What are the main causes of aortic stenosis?

Answer 12

Congenital bicuspid valve
Degeneration/calcification with age
Rheumatic disease

Question 13

Can aortic stenosis patients be asymptomatic?

Answer 13

Yes

Question 14

What are some symptoms of aortic stenosis?

Answer 14

Breathlessness
Chest pain
Dizziness
[less cardiac output]

Question 15

What are some signs of aortic stenosis?

Answer 15

Slow-rising pulse
Heaving apex
Ejection systolic
Radiates to carotid

Question 16

Name some treatment for aortic stenosis

Answer 16

Valve replacement
Balloon valvotomy
TAVI (valve implantation)

Question 17

What are the main causes of mitral regurgitation?

Answer 17

Rheumatic disease
Myxoma in younger people
Endocarditis
Chorda rupture

Question 18

What are some signs of mitral regurgitation?

Answer 18

Displaced apex
Pansystolic
Radiates to axilla

Question 19

Name some treatment for mitral regurgitation

Answer 19

Valve replacement

Diuretics, ACEi

Question 20

What is the main cause of mitral stenosis?

Answer 20

Rheumatic disease

Question 21

What are some symptoms of mitral stenosis?

Answer 21

Breathlessness
Palpitations
Fatigue

Question 22

What are some signs of mitral stenosis?

Answer 22

Malar flush
Tapping apex
Mid-diastolic rumbling

Question 23

Name some treatment for mitral stenosis

Answer 23

Valve replacement
Balloon valvuloplasty
Diuretics, B blocker, digoxin

Question 24

What are the main causes of aortic regurgitation?

Answer 24

Endocarditis
Connective tissue disorders (SLE, rheumatoid)
Marfan’s syndrome

Question 25

What are some signs of aortic regurgitation?

Answer 25

Collapsing pulse
Displaced apex
Early diastolic