Flashcards in *Valvular heart disease Deck (54)
What type of symptoms are characteristic of valvular heart disease?
Exertional symptoms (patients with even severe valve disease don't tend to experience symptoms at rest)
What 4 features of breathlessness suggest cardiac breathlessness?
Related to activity (usually)
Often associated with ankle swelling
Paroxysmal nocturnal dyspnoea
What is a classification system used to assess the extent of heart failure's affect on a patients functional status?
New York Heart Association Functional classification
Classes of New York Heart Association Functional classification?
Class I = no limitation
Class II = Slight limitation of ordinary activity
Class III = marked limitation of less than ordinary activity
Class IV = severe limitation of minimal activity or at rest
Signs of right heart failure? (3)
Pitting oedema (ankles and sacrum (more severe heart failure if in sacrum also))
Does right heart failure have a peripheral or central effect?
Tapping apex beat?
Mitral stenosis (thrusting displaced palpable (but more so than normal) apex beat
Apex beat in left ventricular dilation?
Displaced and diffuse (volume overload)
Apex beat in left ventricular hypertrophy?
Displaced and heaving (pressure overload)
What causes a parasternal heave over the left parasternal edge?
Right ventricular hypertrophy (due to right ventricular overload e.g. cor pulmonale/ pulmonary hypertension)
What is a cardiac murmur?
Audible turbulence of blood flow (can be innocent or pathological)
How to describe murmurs? (6)
Timing? - systolic or diastolic
Type of murmur? - ejection systolic or pan systolic/ early or mid diastolic
Where is it loudest?
Where does it radiate to?
What grade of murmur?
Does respiration influence it?
What murmur radiates to the carotid?
What murmur radiates to the axilla?
What causes the first heart sound?
Mitral and tricuspid valve closing (start of systole)
What causes the second heart sound?
Aortic and pulmonary valves closing (start of diastole)
Ejection systolic murmur?
Early diastolic murmur?
Mid diastolic murmur?
Grading of murmurs?
I - very quiet (dispute of whether it is there or not)
II - quiet - easy to hear
III - loud
IV - loud with a thrill
V - very loud with a thrill
VI - loud - audible without a stethoscope
Are right or left sided murmurs louder with inspiration?
What are the 12 common murmurs?
2nd sound splitting
What is the most common cause of a continuous heart murmur?
What is another name for an innocent murmur?
What are 2 features of an innocent murmur?
Soft (less than 3/6 severity)
Are innocent murmurs systolic or diastolic?
Always systolic (diastolic murmurs are always pathological)
What are the 3 types of valvular heart disease and what causes each?
Valve stenosis - valves which do not open properly
Valve regurgitation - valves which do not close properly
Mixed valve disease - valves which neither open properly nor close properly
What type of symptoms will left heart failure cause?
Pulmonary symptoms and signs