Valves

Question 1

Symptoms of patients with valve disease

Answer 1

Chest pain
Dyspnoea
Syncope

On exertion

Question 2

What is a cardiac murmur?

Answer 2

Audible turbulent blood flow

Question 3

MITRAL REGURGITATION - systolic or diastolic?

Answer 3

Systolic`

Question 4

AORTIC REGURGITATION - systolic or diastolic?

Answer 4

Diastolic

Question 5

MITRAL STENOSIS - systolic or diastolic?

Answer 5

Diastolic

Question 6

AORTIC STENOSIS - systolic or diastolic?

Answer 6

Systolic

Question 7

Where is the AORTIC region?

Answer 7

2nd right intercostal space

Question 8

Where is the PULMONARY region?

Answer 8

2nd left intercostal space

Question 9

Where is the TRICUSPID region?

Answer 9

4th left intercostal space

Question 10

Where is the MITRAL region?

Answer 10

5 left intercostal space, mid-clavicular line

Question 11

TRICUSPID STENOSIS - systolic or diastolic?

Answer 11

Diastolic

Question 12

PULMONARY REGURGITATION - systolic or diastolic?

Answer 12

Diastolic

Question 13

TRICUSPID REGURGITATION - systolic or diastolic?

Answer 13

Systolic

Question 14

PULMONARY STENOSIS - systolic or diastolic?

Answer 14

Systolic

Question 15

How would you describe murmurs?

Answer 15

Timing - Systole or Diastole
Type - Early/Mid/Late systolic or diastolic
Location - APTM?
Radiation - To the neck or axilla?
Grade - Rate out of 6. 1 being very weak. 6 being audible without the stethoscope placed on the chest
Is it influenced by respiration?

Question 16

Which valves close on LUB?

Answer 16

Mitral and tricuspid

Question 17

Which valves close on DUB?

Answer 17

Aortic and pulmonary

Question 18

What are the 2 types of systolic murmur?

Answer 18

Pansystolic or ejection systolic

Question 19

What are the 2 types of diastolic?

Answer 19

Early diastolic (decrescendo)
Mid-diastolic

Question 20

Where does aortic stenosis radiate to?

Answer 20

The carotids`

Question 21

Where does mitral regurgitation radiate to?

Answer 21

The axilla and inferior edge of the scapula

Question 22

Which murmurs are pansystolic?

Answer 22

Mitral regurgitation and tricuspid regurgitation (and ventricular septal defect)

Question 23

Which murmurs are ejection systolic?

Answer 23

Aortic and pulmonary stenosis

Question 24

Which is murmur is early diastolic?

Answer 24

Aortic regurgitation

Question 25

Which murmur is mid-diastolic?

Answer 25

Mitral and tricuspid stenosis

Question 26

A murmur is louder on inspiration, which side of the heart does originate from?

Answer 26

Right side

Question 27

What is stenosis of the valves?

Answer 27

Valves that don't open properly

Question 28

What is regurgitation of the valves?

Answer 28

Valves that don't close properly

Question 29

What is mixed valve disease?

Answer 29

Valves that don't open AND close properly

Question 30

What causes aortic stenosis?

Answer 30

Congenitally bicuspid valve Age related/degenerative Rheumatic

Question 31

What are the symptoms of aortic stenosis?

Answer 31

Initially asymptomatic Breathlessness Chest pain Dizziness/syncope

Question 32

What are the signs of aortic stenosis?

Answer 32

Low volume pulse - slow rising. Forceful apex - LV heave (leads to LV hypertrophy because of increase end diastolic pressure) Ejection systolic murmur radiating to the carotids

Question 33

What is the treatment for aortic stenosis?

Answer 33

Surgery - valve replacement Balloon Aortic valvotomy Transcatheter aortic valve implantation

Question 34

What are the causes of mitral regurgitation?

Answer 34

``` Rheumatic heart disease Myxomatous degeneration (Floppy mitral valves) Endocarditis Chordal rupture Ischaemia/infarction LV Dilatation ```

Question 35

What are the symptoms of mitral regurgitation?

Answer 35

Dyspnoea Ankle swelling Fatigue

Question 36

What are the signs of mitral regurgitation?

Answer 36

Displaced apex beat | Pansystolic murmur - Radiating to axilla

Question 37

What is the treament for mitral regurgitation

Answer 37

Drugs - Diuretics/ACE Inhibitors | Surgery - Valve replacement/repair

Question 38

What are the symptoms of mitral stenosis?

Answer 38

Dyspnoea Tiredness Palpitations

Question 39

What are the causes of mitral stenosis?

Answer 39

Rheumatic heart disease | Congenital (Rare)

Question 40

What are the signs of mitral stenosis?

Answer 40

``` Malar flush Tapping apex beat Mid diastolic murmur (localised to apex) Later stages: Right sided heart failure Straight left heart border on CXR ```

Question 41

What is the treatment for mitral stenosis?

Answer 41

Drugs - Diuretics, beta blockers, digoxin, warfarin. Surgery - valve replacement Mitral balloon valvuloplasty

Question 42

What are the causes of aortic regurgitation?

Answer 42

Infective endocarditis Connective tissue disease - Marfan's Rheumatic heart disease Acute aortic dissection

Question 43

What are the symptoms of aortic regurgitation?

Answer 43

Dyspnoea Chest pain Dizziness

Question 44

What are the signs of aortic regurgitation?

Answer 44

COLLAPSING PULSE Displaced apex Early diastolic murmur lower left sternal edge Cardiomegaly on CXR

Question 45

What is the treatment for aortic regurgitation?

Answer 45

Drugs - ACE inhibitors, ARBs, Diuretic. | Surgery - Valve replacement

Question 46

Which are more common? Left or right sided valve problems?

Answer 46

Left