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Semester 2 > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

MR: etiology

A

ACUTE
- ruptured chordae tendinae, endocarditis, papillary muscle rupture, trauma

CHRONIC
- rheumatic heart disease, ischemia, endocarditis, Marfans, MVP

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2
Q

MR: pathophysiology

A

pure VOLUME overload
- LA enlargment, LVH, increased contractility
- pulmonary HTN
- LV dilation
- symptoms of right HF
- 20 - 30 yrs to develop

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3
Q

MR: PE

A
  • soft S1
  • holosystolic (apex); radiates to axilla
  • S3
  • CHRONIC: intensity = severity
  • exertional dyspnea
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4
Q

Which valvular diseases do you NOT prophylax?

A

Mitral stenosis/regurg, ASD

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5
Q

Narrow pulse pressure

A

aortic stenosis

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6
Q

Wide pulse pressure

A

aortic regurgitation

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7
Q

Midsystolic CLICK

A

MVP

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8
Q

Most common reason for severe MR

A

MVP

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9
Q

AS: etiology

A
  1. Normal wear + tear with old age
  2. bicuspid valve
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10
Q

Valvular disease associated with angina

A

aortic stenosis (30-50%)

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11
Q

People with CAD most likely have this valvular disease

A

aortic stenosis

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12
Q

thrill at left sternal border

A

aortic stenosis

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13
Q

upstroke of carotids (pulsus tardus)

A

aortic stenosis

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14
Q

With AS, you should avoid THESE treatments

A

nitrates, beta blockers, CCBs

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15
Q

With AR, you should avoid THESE treatments

A

beta blockers, balloon pump (ACUTE)

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16
Q

thrill in carotid

A

aortic regurgitation

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17
Q

florid pulmonary edema

A

aortic regurgitation

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18
Q

AR: treatment

A
  1. (+) inotrope (dobutamine)
  2. vasdilator (nitroprusside)
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19
Q

AR: etiology

A

ACUTE
- endocarditis, dilated aortic root, aortic dissection

CHRONIC
- bicuspid aortic, idiopathic aortic root dilation, SYPHILIS, rheumatic fever, infective endocarditis

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20
Q

AS: onset of symtoms

A

mortality = 90% within a few years

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21
Q

AR: onset of symptoms

A

asymptomatic until 40s - 50s

  • 4-6% progression / year
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22
Q

AR: symptoms

A

dyspnea, nocturnal angina, palpitations

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23
Q

Austin Flint murmur

A

aortic regurgitation

24
Q

Graham Steel murmur

A

pulmonary regurgitation

25
Q

Traube’s sign

A

aortic regurgitation

26
Q

diastolic blowing murmur

A

aortic regurgitation

27
Q

AR: treatment

A
  • digitalis, diuretics, vasodilators
  • prophylaxis
28
Q

Rule of 55

A

end systole diameter >55mm OR EF <55% OR symptomatic = refer to specialist

29
Q

AR: indications for surgery

A

ANY symptoms at rest/exercise

30
Q

holosystolic murmur

A

HMTR-VSD

31
Q

crescendo-decrescendo murmur

A

ICDPAS

32
Q

continuous, machine-like murmur

A

PDA

33
Q

MS: etiology

A

RHEUMATIC HEART DISEASE

34
Q

MS: pathology

A

progressive dyspnea (70%)

35
Q

hemoptysis

A

mitral stenosis

36
Q

opening SNAP early-mid diastolic RUMBLE

A

mitral stenosis, tricuspid stenosis

37
Q

pulmonary rales

A

mitral stenosis

38
Q

prominent “A” wave in jugular vein pulsations

A

mitral stenosis

39
Q

MS: diagnosis

A

echo (TTE/TEE)

40
Q

MS: treatment

A

Symptomatic: surgery with Class III or IV
Asymptomatic: balloon valvuloplasty

41
Q

wide split fixed S2

A

ASD

42
Q

Most common ACYANOTIC congenital heart
lesion in infants

A

VSD

43
Q

VSD accounts for _____% of congenital heart defects and _______ close before the age of _______

A

VSD accounts for 30% of congenital heart defects and 1/2 close before the age of 4

44
Q

What structure closes as the newborn takes its first breath?

Will this increase or decrease pulmonary vascular pressure?

How does it do this?

A

Ductus arteriosus

decrease PVR

bradykinins release and constrict smooth wall

45
Q

Where can coarctation of the aorta be best heard?

A

L subclavian artery

46
Q

Which CHD results in discrepancies between upper and lower extremities?

A

coarctation of the aorta

47
Q

Notching of the ribs is associated with

A

Coarction of Aorta POSTDUCTAL

48
Q

Best test for Dx coarctation of aorta

A

TEE

49
Q

Cyanotic Congenital Heart Disease is due to

A

right to left shunt (Eisenmenger’s Syndrome)

50
Q

When do you see Eisenmenger’s Syndrome

A

See with end stage ASD, VSD, PDA

51
Q

4 Hallmarks of Tetralogy of Fallot

A
  1. Pulmonary stenosis
  2. Overriding aorta
  3. VSD
  4. Hypertrophy of the RV
52
Q

What bypasses pulmonary capillary bed
causing R to L shunt?

A

pulmonary AV fistula

53
Q

Polycythemia, clubbing, cyanosis, hemoptysis, NORMAL heart is associated with

A

pulmonary AV fistula

54
Q

reversal of aorta and pulmonary artery

A

transposition of the great vessels

55
Q

ACUTE endocarditis:
Frequently caused by ________________
Occurs on ____________ valves

A

ACUTE endocarditis:
Frequently caused by STAPH. AUREUS
Occurs on NORMAL + DAMAGED valves

56
Q

SUBACUTE endocarditis:
Frequently caused by ________________
Occurs on ____________ valves

A

SUBACUTE endocarditis:
Frequently caused by STREP VIRIDINS
Occurs on damaged valves

57
Q

Bacteria responsible for infective endocarditis in IV drug abusers

A

Staph. aureus

Semester 2 (5 decks)

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