Valvular Disease Flashcards by Shelby SK

What is the first line treatment for the management of ACUTE mitral regurgitation

IV nitroprusside

Prep for surgery

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What would cause supravalvular aortic stenosis

Congenital or post-operative

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When do you hear a murmur associated with pulmonic stenosis

Mid systolic

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What is the treatment for chronic aoritc regurgitation

Vasodilators (reduce regurgitant volume + increase ejection fraction)

Specifically ACE inhibitors are most helpful

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What is the management for mitral steonisis if they also have A FIB or a history of emboli or significant left atrial enlargement

Warfarin (INR 2-3)

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What is a “water hammer” or “corrigan pulse”

Wide pulse pressue asscoated with aortic regurgitation

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What is the character of the murmur associated with aortic stenosis

Crescendo-decrescendo

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Papillary muscle dysfunction post-MI can lead to what valve disorder

Mitral regurgitation

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What position can you put the patient in to better hear tricuspid regurgitation

Inspiration

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When do you hear a murmur assocated with tricuspid regurgitation

Pan-systolic

Allll of the systole

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Which is more common, acute or chronic aortic regurgitation

Chronic

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What is the management for mitral valve prolapse

Life style changes

**if arrhythmia = beta blockers

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What are triggers for symptoms for mitral stenosis

Sudden exertion
Excitement
Fever
Severe anemia
Tachycardia
Sexy time
Preggo
Thyrotoxicosis
A fib

***bolded on the slides

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Low pitch “rumble”, S1 accentuated, opening snap after S2 diastolic murmur heard at the apex

Mitral Stenosis

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Where do you hear tricuspid regurgitation best

LLSB

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When is a hypertrophic cardiomyopathy murmur louder, with valsalva or squatting

Valsalva

Which is opposite of valvular aortic stenosis

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When do you hear a murmur associated with mitral stenosis

Mid-late diastole

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What would cause subvalvular aortic stenosis

Congenital or

Hypertrophic cardiomyopathy

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When do you hear a murmur associated with aortic regurgitation

Diastole

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Where do you hear pulmonic regurgitation best

2 LICS

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If someone has mild, asymptomatic aortic stenosis, what is the treatment?

Educate about symptoms

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What is the treatment for chronic mitral regurgitation

ACE inhibitors
Vasodilators
Diuretics
Digitalis
Warfarin (INR = 2-3)

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What is the treatment for acute aortic regurgitation

Urgent cardiology consult

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Which murmur is the MOST associated with rheumatic disease

Mitral stenosis

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Which murmur can often radiate to the neck

Aortic stenosis

When do you hear a murmur associated with aortic stenosis

Mid systolic

Medium pitch, blowing, radiates to right sternum and xiphoid pansystolic murmur heard best at LLSB

Tricuspid regurgitation

What are the benefits and downsides to tissue valves for aortic stenosis

Benefit: no warfarin Downside: does not last as long

With chronic aortic regurg, patients will eveltually develop signs of:

Heart failure

If someone has a prosthetic valve to treat aortic stenosis, what are the benefits and downsides?

Benefit: lasts longer Downside: life long warfarn

Where do you hear pulmonic stenosis best

2-3 LICS

Where do you hear aortic regurgitation best

2-4 LICS

When do you hear a murmur associated with mitral regurgitation

Pansystolic Alllll of systole

Where do you hear aortic stenosis best

2 RICS

Medium pitch, harsh, radiates to left should and neck mid-systolic murmur heard best at 2nd-3rd LICS

Pulmonic Stenosis

Which murmurs are associated with being pan-systolic

Mitral and tricsupid REGURGITATION

S4 gallop makes you think:

Pulmonary hypertension

What position can you put the patient in to better hear pulmonic regurgitaiton

Inspiration

If someone has moderate, asymptomatic aortic stenosis, what is the treatment?

Annual check up

“Opening snap followed by mid-diastolic rumbling murmur”

Mitral stenosis

High pitch, blowing, secrescendo, radiates to apex diastolic murmur heard and the 2nd-4th LICS

Aortic regurgitation

What abnormality could you potentially see on a CXR of someone with aortic stenosis

Post-stenotic dilation of aorta

What is the most common cause of mitral stenosis

Rhematic heart disease BY FAR

What is an Austin-Flint murmur?

Soft, low-pitched doastolic murmur at the apex which sounds like a mitral stenosis murmur

Low pitch, may have opening snap, mid-late diastolic murmur heard best at LLSB

Tricuspid stenosis

What do you see on an echo of aortic stenosis

Immobile, calcifed leaflets

What are the two types of prosthetic aortic valves

Ball and cage | Tilting valve

Which valve disease is assocated with a SMALL pulse pressure

Aortic stenosis

What happens to the valves with rheumatic heart disease

Diffusely thickened due to fibrous tissue/calcium deposits Leaflets = immobilized and rigid

Aortic stenosis patient education 3 major things

Avoid STRENUOUS activity Avoid dehydration Pay attention to signs of worsening disease aka symptoms

In what position is mitral stenosis best heard

Left lateral decubitus position At the apex with the bell

Where do you hear tricuspid stenosis best

LLSB

What are two etiologies for acute aortic regurgitations

Aortic dissection Infective endocarditis

What is the best diagnostic study for valvular disorders

``` ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ECHO ```

When is someone indicated for surgery with aortic stenosis

SYMPTOMATIC OR SEVERE

Medium to high pitch, blowing, radiates to left axilla pansystolic murmur heard best at the apex

Mitral Regurgitation

What position can you put the patient to best hear aortic stenosis

Patient sitting, leaning forward Squatting

Which murmur is associated with “RUMBLING”

Mitral stenosis

MId-late systolic click (left) =

Mitral valve prolapse

Which valve disease has sxs usually due to pulmonary congestion

Mitral stenosis

Where do you hear mitral stenosis best

Apex

What is the management of SYMPTOMATIC aoritc stenosis

Cardiac catherization | Valve replacement may be needed

What is the treatment for mitral stenosis if they have mild symptoms only

Diuretics Stop eating so much salt

Mitral valve prolapse can lead to what other valve disorder

Mitral regurgitation

What is the treatment for tricuspid and pulmonic valve disorders

Sodium restriction Diuretics Surgical repair or replacement

High pitch, blowing, descrescendo early diastolic murmur heard best at 2nd LICS

Pulmonic Regurgitation

Medium pitch, harsh, crescendo-decrescendo systolic murmur at the 2nd RICS that radiates to the neck

Aortic Stenosis

If someone has aortic stenosis and is between the ages of 30-65, what is the most likely cause?

Congenital bicuspid valve which becomes calcified and stenotic Also rhematic valve disease

What are the 3 surgiers for mitral stenosis

Valvuloplasty Mitral commisurotomy Prosthetic valve

When do you hear a murmur associated with pulmonic regurgitation

Early distaole

What is the main etiology for aortic regurgitation

Rheumatric valvular disease Connective tissues diease (RA, Mafran, Ehler-Danlos)

“Abnormalities of valve leaflets” make you think of what valve disease

Mitral regurgitation

What position can you put the patient in to better hear tricuspid stenosis

Increases with inspiration Squatting

Rheumatic heart disease makes me think of which valve diseases

Aortic regurgitation Aortic Stenosis Mitral regurgitation Mitral Stenosis

Where do you hear mitral regurgitation best?

Apex

When do you hear a murmur associated with tricuspid stenosis

Mid-late diastole

Huge left atrium with left ventricular hypertrophy is a severe consequence of which valve disease

Mitral regurgitation

If someone has aortic stenosis and is under the age of 30, what is the most likely cause?

Unicuspid valve

What is the aortic stenosis triad

Angina Syncope Heart failure

What is the INR range for someone with a prostehtic valve from aortic stenosis

2.5-3.5

A mitral stenosis murmur can also sound like what other type of murmur

Austin-Flint murmur

Wide pulse pressure makes you think of what valve disease

Aortic regurgitation

Which valve disorer is a pretty common condition, up to 2.5% of the general population

Mitral valve prolapse

Mitral stenosis is commonly associated with what other cardiac abnormality

ATRIAL FIBRILLATION

What murmurs could produce an “opening snap” sound

Mitral or tricuspid STENOSIS

“Radiates to the axilla” + “pansystolic murmur” =

Mitral regurgitation

If a patient has mitral stenosis, what other thing do 40-50% of patients also have?

A fib

What position can you put the patient in to better hear aortic regurgitation

Patient sitting, leading forward, full exhalation

Valvular Disease Flashcards

(88 cards)