Valvular disorders P1 AND P2 trigger Flashcards by Billie Roberts

Presents medium pitched, harsh quality with thrill

aortic stenosis

How well did you know this?

Not at all

Perfectly

2 ICS w radiation to carotids

aortic stenosis

How well did you know this?

Not at all

Perfectly

midsystolic

aortic stenosis or MVP

How well did you know this?

Not at all

Perfectly

CXR with dilated ascending aorta, enlarged cardiac sihouette

CXR for aortic stenosis

also see:
Calcified aortic valve

How well did you know this?

Not at all

Perfectly

can be treated with statins

aortic stenosis

How well did you know this?

Not at all

Perfectly

can be caused by aortic dissection and marfans

aortic regurgitation

How well did you know this?

Not at all

Perfectly

widened pulse pressure on PE

aortic regurgitation

How well did you know this?

Not at all

Perfectly

austin flint murmur

aortic regurgitation

How well did you know this?

Not at all

Perfectly

S3 OR S4 gallop

aortic regurgitation

How well did you know this?

Not at all

Perfectly

S4 gallop

Aortic stenosis

OR
aortic regurg

How well did you know this?

Not at all

Perfectly

laterally displaces apical impulse

aortic stenosis

How well did you know this?

Not at all

Perfectly

low pitched, diastolic murmur, heard at apex

This describes the austin flint murmur

but could also describe mitral stenosis!

How well did you know this?

Not at all

Perfectly

Holo diastolic murmur

aortic regurgitation
or
SEVERE pulmonic regurgitation

How well did you know this?

Not at all

Perfectly

high pitched and blowing murmur

aortic regurgitation
or
pulmonic regurgitation

How well did you know this?

Not at all

Perfectly

what are the AVR surgery indications in aortic valve regurg

BEFORE THESE HAPPEN:
LV dilation >5cm
EF <50%

How well did you know this?

Not at all

Perfectly

treat with BB

aortic regurgitation

How well did you know this?

Not at all

Perfectly

in patients who are poor candidates for open heart surgery or are of intermediate risk, what treatment would be used for aortic stenosis

TAVR

How well did you know this?

Not at all

Perfectly

when would you use ARBS instead of BB in an aortic regurg patients

in patients with marfans syndrome

How well did you know this?

Not at all

Perfectly

can be caused by infective endocarditis, root dissection, and acute dysfunction of prosthetic valve

acute aortic regurgitation

can also be caused by traumatic rupture of aortic leaflets

How well did you know this?

Not at all

Perfectly

heard best with patient sitting and leaning forward

aortic regurgitation and stenosis

How well did you know this?

Not at all

Perfectly

results in hemodynamic instability, pulmonary congestion, and pulmonary edema.

acute aortic regurgitiation

How well did you know this?

Not at all

Perfectly

low pitched, early diastolic murmur with rapid pulse

suggestive of cardiogenic shock!

symtpoms also include:
pale, cool extremities
weak, rapid pulse

How well did you know this?

Not at all

Perfectly

when is a stat echo used

acute aortic regurgitataion

How well did you know this?

Not at all

Perfectly

CXR showing cardiomegaly with LV prominence

acute and normal aortic regurgitation

How well did you know this?

Not at all

Perfectly

could treat with hydralazine and furosemide if BP is stable. may need inotropic agents or vasopressors

acute aortic regurgitation (treat with vasodilator and diuretics if stable BP)

what is affected by marfans disease

the aortic root, therefore causing aortic regurg

MC demographic is women

tricuspid stenosis

LA enlargement

Mitral stenosis (initial hemodynamic change, may result in pulm congestion)

leads to right sided HF due to increased in pulmonary vascular resistance

mitral stenosis

typically develope symptoms of this disease in 4th-5th decade of life

Mitral stenosis (20-40 years following illness)

fatigue, exertional dyspnea, orthopnea

mitral stenosis

afib, hemoptysis, blood tinged sputum

mitral stenosis may also see: peripheral embolism pulmonary edema hoarsness as result of left recurrent laryngeal nerve compression

patient presenting with hoarsness and pulmonary edema

mitral stenosis hoarsness d/t left recurrent laryngeal nerve compression also presents with afib hemoptysis blood tinged sputum

low-pitched, rumbling, diastolic murmur best heard at apex

mitral stenosis

best heard in LLD

mitral stenosis

S1 loud early on and opening snap heard following S2

mitral stenosis

EKG shows LA abnormality and RV hypertrophy pattern. also shows afib

Mitral stenosis

"hockey stick" of anterior MV leaflet

echo result for mitral sttenosis

what cannot be done in degenerative AS due to a high restenosis rate

balloon valvuloplasty

soft high pitched diastolic rumble. hear better on inspiration

tricuspid stenosiswh

what murmurs have an "opnening snap?"

mitral and tricuspid stenosis! these murmurs are so similar except mitral is LOW picthed and tricuspid is HIGH pitched. also tricuspid is heard better on inspiration

WHY IS tricuspid stenosis increased during inspiration and mitral is not? (i didnt get this and now i do)

increased venous return in inspiration!!! tricuspid recieves venous blood from body, mitral just recieves from lungs.

EKG shows right atrial enlargement

tricuspid stenosis

treated with loops (torsemide or bumetanide) with addisiton of aldosterone antagonist if needed

Tricuspid stenosis! loops for HF aldosterone antagonist for liver congestion/ascities

palpable systolic liver pulsation

tricuspid regurgitation and stenosis

accentuated by leg raising and inspiration

tricuspid regurgitation

high pitche and pansystolic best heard at left sternal border

tricuspid regurgitation

EKG showing afib. cardiac cath showing elevated RA pressure

Triscuspid regurgitation

this murmur is typically a result of congenital defects such as noonan syndrome or trisomy 13

pulmonic stenosis rare to be caused by anything else

progressive fatigure and dyspnea on exertion in adolesents or young adults is suggestive of what problem

pulmonic stenosis

what problem causes neonates to present at birth with cyanosis

pulmonic stenosis

presents with ejection murmur that increases during inspiration

pulmonic stenosis

RBBB seen on EKG

pulmonic regurgitation

caused by pulm HTN

pulmonic regurgitation

when do you do surgery in pulmonic regurgitation

very rarley, only if there is intractable RV failure

which valve replacement option is associated with LOWER risk of thromboembolic events?

tisssue!!! = less clot probability = plavix mechanical = more clot probablility = warfarin!!!

EKG with LA abnormality, LVH pattern with possible afib

mitral regurgitation

treat with ACEI or hydralazine. also diuretics

mitral regurgitation afterload reduction is ACEI or hydralazine diuretics is for pulm congestion/edema

disease of aortic leaflets, aortic root or both

aortic regurgitation causes

leads to LVH and diastolic dysfunction

aortic stenosis

when are inotropic agents and vasopressors used

acute aortic regurgitation

which causes pulm edema and HTN and therefore leads to R sided HF

mitral stenosis

who is NOT a candidate for balloon valvuloplasty in MS

* patients with calcified leaflets and chords * LA thrombus

caused by posterior wall MI MV prolapse LV dilation

mitral regurgitation

in a male patient >40 or a menopausal patient w R sided HF what is used to assess mitral regurgitaition

cirinary angiography