Valvular Disease Flashcards
(41 cards)
What creates the first heart sound?
Mitral and tricuspid valves closing
What creates the second heart sound?
Aortic and pulmonary valves closing
When is a systolic murmur heart?
Between S1 and S2
When is a diastolic murmur heard?
After S2
Where do you auscultate the aortic valve?
Right, 2nd/3rd intercostal space
Where do you auscultate the pulmonary valve?
Left, 2nd/3rd intercostal space
Where do you auscultate the tricuspid valve?
Left sternal border
Where do you auscultate the mitral valve?
Apex
Which murmur classically radiates to the carotids?
Aortic stenosis
Which murmur classically radiates to the axilla?
Mitral regurgitation
What are some of the presenting features with a murmur?
Reduced functional capacity –> exertion symptoms are characteristic of valvular disease
- chest pain
- SOB
- collapse
What are the invasive and non invasive options for investigating a murmur?
Non invasive - Echo
Invasive - cardiac catheterisation
What type of murmur is aortic stenosis?
Ejection systolic
Radiates to carotids
How would you describe the pulse in aortic stenosis?
Slow rising
What are some causes of aortic stenosis?
Degenerative (age related)
Congenital - bicuspid valve
Rheumatic
What are the treatment options for aortic stenosis?
Conventional valve replacement
TAVI - trans catheter aortic valve implantation
Balloon aortic valvotomy (BAV)
What are the two types of prosthetic heart valves?
Mechanical e.g. metal
Bio-prosthetic e.g. pig valve
Which type of prosthetic valve is best in younger patients and why?
Mechanical –> lasts longer
Which type of prosthetic valve is best in older patients and why?
Bio-prosthetic –> have to take warfarin
only lasts 10 years
When would TAVI be used over conventional valve replacement surgery?
If significant co-morbidites meaning surgery not possible
surgery favoured otherwise
What type of murmur is mitral regurgitation?
Pansystolic
Radiating to the axilla
What are some of the clinical features of mitral regurgitation?
SOB
Peripheral oedema
Fatigue
Displaced apex
Which structural abnormality is often seen with mitral regurgitation?
LV dilatation
How is mitral regurgitation managed?
Medication –> treat HF
Surgery –> repair/replace
