Valve Disease (Newman) Flashcards Preview

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Flashcards in Valve Disease (Newman) Deck (55):
1

2 causes of endocarditis

bugs in blood and diseased valve

2

What determines the integrity of the valves?

leaflets/cusps
support network
cardiac chambers, great vessels

3

a narrowing of an orifice, lumen

stenosis

4

leakage upstream

regurgitation

5

What the size diff of healthy and stenotic valve?

3 cm vs 0.5 cm

6

in what valve does regurgication happen most common?

aorta (in diastole) >> mitral/left ventricle (in systole)

7

What is the cardiac adaptation to a stenotic valve?
Does a stenotic valve cause a pressure or volume overload?

inc thickness of wall = concentric hypertrophy

(pressure overload due to inc pressure upstream)

8

What is the cardiac adaptation to regurgitation?
Does a regurgitation cause an pressure or volume overload?

eccentric hypertrophy (enlarged chamber inc mass but normal thickness)

= heart dialtes without getting thicker!!
(volume overload bc volume increases upstream)

9

What is the thickness of the inter-ventricular septum?

1 cm

10

loud murmur without hypertrophy (eccentric)

acute regurgitation

11

What causes acute regurg? (3)

ischemia, infection, dissection

12

heart failure (PND, edema, JVD)
chest pain
syncope
arrhymias
** could be asymptomatic

acute regurgitation

chest pain (angina)

13

Where on the chest would you hear mitral regurg

right under left nipple

14

mitral regurg murmur is heard during _____

systolic murmur
lub --fhh--dub

15

aortic regurg murmur is heard during _____

diastolic murmur
lub-dub-fhh

16

Where on the chest would you hear aortic regurg?

under right clavicle

17

aortic stenosis murmur is heard during _____

Systole
lub-ugh-dub (cough sound)

18

in mitral stenosis the first heart sound is

louder

19

how must a pt be positioned? WHat part of hand do you use to feel for it?

left lateral dequibitis
interphalngeal joints

20

Where will PMI be felt with eccentric hypertrophy?

axilla

21

What should the size of the PMI be normally? pathologic?

size of dime--> quarter

22

concentric hypertrophy is a risk factor for ...

CAD

23

the gradient

?
left ventricle pressure < aorta

24

to determine the severity of the stenosis you must know...

gradient
CO (or Q)

25

inflammation, scarring of leaflets, chordae, and papillary muscles, frequent calcification

mitral stenosis

26

Clinical pres:
dyspnea, RHF, thrombi

mitral stenosis

27

HTN: left atrium > pulmonary bed > right heart

mitral stenosis

28

pulmonary artery catheter measures

left ventricular pressure?

29

disease affecting:
supporting valve structures
leaflets
dilation of left atria

mitral regurg

30

loud first heart sound

mitral stenosis

31

what is the most common cause of mitral regurg?

mitral prolapse

32

leaflets replaced by myxomatous tissue

mitral valve prolapse --> mitral regurg

33

eccentric hypertrophy is the result of

Chronic mitral regurg

34

inc preload with dec afterload

mitral regurg

35

What are the 2 most common causes of mitral regurg?

infection (endocarditis)
ischemia (MI)

36

loud murmus, pulmonary edema, without enlarged ventricle or atia

acute mitral regurg

37

hwo is accute and chronic regurg diff?

lack of hypertrophy = acute

38

lub- ugh -dub heard under right clavicle

aortic stenosis

39

tardus

delayed arterial pressure (stays a little longer on your finger)

40

parvus

weakened arterial pulse

41

concentric hypertrophy + tardus + parvus

aortic stenosis

42

angina
syncope
HF
sudden death

arotyic stenossi

43

lub-dub-shh under right clavicle

aortic regurg

44

wide pulse pressure

chronic aortic regurg

45

bacteremia + disease valve (or lesion)

2 requirements for endocaditis

46

combo of platelets + fibrin + bugs + RBCs and WBCs

vegetation

47

valve destruction -->

acute regurg

48

complications of infective endocarditis

valve destruction --> acute regurg
embolization
immunologic phenomena

49

What are the 3 indications for surgery in IE

1. heart failure unresponsive to medical management
2. uncontrolled infection
3. recurrent major emboli

50

Turbulent flow is indicative of...

stenosis

51

Inappropriate timing is indicative of...

regurgitation

52

Severity of stenosis is determined by:

pressure gradient
CO

53

In mitral stenosis, the severity is proportional to

HR

54

SIgns of aortic regurg

widened pulse pressure
head bobbing

55

Endocarditis requires:

bacteremia
diseased valves