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Flashcards in Valvular Heart Disease Deck (14):
1

etiology of mitral stenosis

rheumatic with the exception of rare congenital forms

2

symptoms of mitral stenosis

dyspnea from pulmonary congestion

fatigue from low output

3

describe the hemodynamics of mitral stenosis

increased atrial pressures

presence of a murmur

as the pressure increases over time, the opening snap occurs earlier and earlier

4

physical findings of mitral stenosis

normal to decreased LV impulse

increased RV impulse

loud first heart sound

opening snap in early systole

diastolic rumble with presystolic accentuation

signs of pulmonary hypertension

5

the effect of mitral balloon valvotomy on mitral stenosis

decreases left atrial pressures

restores pressures during diastole and systole

not complete recovery

6

treatment of mitral stenosis

diruetics to reduce pulmonary venous congestion

beta blockers to prevent tachycardia

digoxin and/or beta blockers in patients with afib to control ventricular rate

anticoagulants to prevent emboli

percutaneous balloon mitral valvotomy (PBMV)

surgical mitral valve commissurotomy

surgical mitral valve replacement

7

aortic stenosis pathophysiology

obstruction to LV outflow

leads to LV hypertrophy

elevated LV diastolic pressures

pulmonary congestion

LV systolic dysfunction

MI

low CO

8

etiology of AS

conegnital

degenerative (calcific)

rheumatic

9

symptoms of AS

dyspnea

angina

presyncope and syncope

10

physical findings of AS

sustained LV impulse

systolic thrill

delayed carotid upstroke

soft second heart sound, often with paradoxic splitting

midsystolic outflow murmur

apical fourth heart sound

11

treatment of AS

no medical treatment

when symptoms develop, surgery is essential

transcatheter aortic valve implantation

12

describe the hemodynamics of aortic stenosis

Louder, then softer - decrescendo murmur

The carotid arteries are also delayed

Emptying of the ventricle into the aorta is delayed

Murmur and delay in upstroke are key findings

13

paradoxic splitting

splitting during expiration in patients with aortic stenosis because it takes longer for the valve to close

14

benefits of aortic valve replacement

improve symptoms

improves LV function

improves survival

no evidence that replacement improves outcomes in asymptomatic patients