Valvular Heart Disease Flashcards Preview

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Flashcards in Valvular Heart Disease Deck (55):
1

when do patient with valvular heart disease characteristically get symptoms?

on exertion

2

how do you describe a murmur?

systole or diastole?
what type of murmur?
where is it loudest?
where does it radiate to?
what grade of murmur?
is it influenced by respiration?

3

what 4 murmurs are systolic?

mitral regurgitaiton
tricuspic regurgitation
aortic stenosis
pulmonary stenosis

4

what 4 murmurs are diastolic?

mitral stenosis
tricuspid stenosis
aortic regurgitaion
pulmonary regurgitation

5

what is a pansystolic murmur?

equal throughout systole

6

what are pansystolic murmurs the result of?

regurgitation of blood flow
mitral/tricuspid regurgitation

7

what are ejection systolic murmurs?

during systole sound gets louder than softer

8

what are ejection systolic murmurs the result of?

stenosis
(aortic/pulmonary stenosis)

9

what type of murmurs radiate?

systolic murmurs

10

what is an early diastolic murmur?

aortic/pulmonary regurgitation

11

what is a mid diastolic murmur?

mitral/tricuspid stenosis

12

which murmurs are always pathological?

diastolic murmurs

13

where do aortic systolic murmurs radiate to?
(aortic stenosis)

neck

14

where do pulmonary systolic murmurs radiate to?
(pulmonary stenosis)

left shoulder

15

where do tricuspid systolic murmurs radiate to?
(tricuspid regurgitation)

dont radiate

16

where do mitral systolic murmurs radiate to?
(mitral regurgitation)

under left axilla

17

describe murmur grading?

1. very quiet
2/3. loud without thrill
4/5. loud with thrill
6. loud- audible without stethoscope

18

which sided murmurs will vary with inspiration?

right sided murmurs will be louder on inspiration than expiration

(eg tricuspid and pulmonary murmurs will vary with inspiration)

19

what are the 3 characteristics of an innocent murmur?

-everything else is normal
-occurs in early systole
-usually located in pulmonary area but no where else

20

what is valve stenosis?

valves dont open properly

21

what is valve regurgitation?

valves don't stay closed properly

22

what is mixed valve disease?

valves neither open properly or close properly

23

what are the 3 main causes of aortic stenosis?

congenital bicuspid aortic valve
age-related calcification
rheumatic

24

what are the symptoms of aortic stenosis?

breathlessness
chest pain
dizziness/syncope on exertion

25

what are the signs of aortic stenosis?

-low volume pulse
-forceful apex- LV heave
-ejection systolic murmur which is maximal in aortic area and radiates to the carotids

26

what are the 3 treatment options for aortic stenosis?

-surgery: valve replacement
-balloon aortic valvotomy
-transcatheter aortic valve implantation

27

what are the 2 types prosthetic heart valves?

mechanical
bioprosthetic

28

what are the advantages and disadvantages of mechanical heart valves compared to bioprosthetic?

mechanical have long term durability but need anticoagulants
biporsthetic dont need anticoagulants but aren;t as durable

29

what are 4 problems can cause mitral regurgitation?

problems with mitral valve leaflets
chordal rupture
ischamia or infarction of papillary muscle
annular dilation

30

why does annular dilation cause regurgitation?

because valves no longer meet in the middle so are leaky

31

what 3 things can cause problems with mitral valve leaflets and so cause mitral regurgitation?

-rheumatic heart disease
-myxomatous degeneration (floppy mitral valve syndrome)
-endocarditis

32

what are the symptoms of mitral regurgitation?

breathlessness
ankle swelling
fatigue

33

what are the signs of mitral regurgitation?

-displaced apex beat
-pansystolic murmur which is maximally heard at the apex and radiated to the axilla

34

what is a sign of mitral regurgitation on a cxr?

cardiomegaly

35

what are the treatment options of mitral regurgitation?

drugs
surgery
percutaneous mitral valve repair

36

what are the 2 drugs that can be used for mitral regurgitation?

diuretics
ACE inhibitors

37

what are the 2 surgery options of mitral regurgitation?

valve repair
valve replacement

38

what are the causes of mitral stenosis?

rheumatic heart disease (although past history my be absent)
congenital

39

what are the symptoms of mitral stenosis?

breathlessnes
tiredness
palpitations

40

what are the signs of mitral stenosis?

-malar flush
-tapping apex beat
-mid diastolic murmur localised to apex
-right heart failure in later stages

41

what valvular heart murmur is most likely to give you palpitations?

mitral stenosis

42

what valvular heart murmur is most likely to give you AF?

mitral stenosis

43

what are the signs of mitral stenosis on a CXT?

straight left heart border
(because left atrium enlarges)

44

what are the 3 treatment options for mitral stenosis?

drugs
surgery
mitral balloon valvuloplasty

45

what drugs are given in the treatment of mitral stenosis?

diuretics (for oedema) betablockers, digoxin, warfarin (for AF)

46

what type of surgery is used in mitral stenosis?

valve replacement

47

when is mitral balloon valvuloplasty suitable for the treatment of mitral stenosis?

if there is a pliable competent valve

48

what are the causes of aortic regurgitation?

defect with the aortic leaflets
defects with the annulus

49

what can cause problems with the aortic leaflets?

infective endocarditis
connective tissue disease
rheumatic heart disease

50

what can cause problems with the aortic annulus?

marfans syndrome
acute aortic dissection

51

what are the symptoms of aortic regurgitation?

breathlessness
chest pain
dizziness

52

what are the signs of aortic regurgitation?

collapsing pulse
displaced apex
early diastolic murmur heard maximally in the tricuspid area

53

what are the treatment options of aortic regurgitation?

drugs
surgery

54

what drugs are used in the treatment of aortic regurgitation?

ACEI
ARB
diuretics

55

what surgery is used in the treatment of aortic regurgitation?

valve replacement