Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CARD - 1 > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

(65 cards)

Start Studying
1
Q

What are three common aetiologies of mitral stenosis?

A

RHEUMATIC FEVER, RHEUMATIC FEVER, RHEUMATIC FEVER

Rarer causes - mucopolysaccharidoses, carcinoid and endocardial fibroelastosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the features of mitral stenosis?

A 
Mid-late diastolic murmur (best heard in expiration)
Loud S1, opening snap
Low volume pulse
Malar flush 
AF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are features of severe MS?

A

Length of murmur increases

Opening snap becomes closer to S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What might you see on CXR in MS?

A

Left atrial enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is mitral regurgitation?

A

When blood leaks back through the mitral valve on systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most common valve disease?

A

Aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the second most common valve disease?

A

Mitral regurg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is the mitral valve located?

A

Between the L atrium and ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can MR lead to?

A

Less efficient heart as less blood is pumped through the body with each contraction

NOTE: it is common in otherwise healthy patients to a trivial degree and does not req. treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

As the degree of regurg in MR becomes more severe what happens?

A

Bodys O2 demands may exceed what the heart can supply –> myocardium thickens

Can lead to patient becoming fatigued as thicker myometrium is less efficient and –> irreversible heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are RFs for mitral regurgitation?

A 
Female sex
Low BMI
Age
Renal dysfunction
Prior MI
Prior mitral stenosis or valve prolpase
Collagen disorders, e.g. Marfans, EDS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can rheumatic fever cause mitral regurg?

A

Causes inflammation of the valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can MR occur post-CAD/MI?

A

If papillary muscles/chordae tendinae are affected by cardiac insult, mitral valve disease may ensue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is mitral valve prolapse?

A

Leaflets of mitral valve are deformed so valve doesn’t close properly and allows for backflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How can IE lead to mitral regurg?

A

Vegetations colonising the valve prevent it closing properly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are causes of mitral regurg?

A 
CAD/MI
Mitral valve prolapse
IE
Rheumatic fever
Congenital
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are symptoms of MR?

A

Usually asymptomatic

May have symptoms due to failure of left ventricle, arrhythmias, pulmonary hypertension (SoB, fatigue, oedema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are signs of MR?

A

Pansystolic blowing murmur
Heard best at apex and radiates to axila
S1 quiet (due to incomplete closure of valve)
Severe MR may cause widely split S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What might you see on ECG with MR?

A

Broad P wave (indicative of atrial enlargement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What might you see on CXR in MR?

A

Cardiomegaly (with enlarged left atrium and ventricle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What investigation is crucial to the diagnosis of MR?

A

Echocardiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How is MR managed?

A

Medical mx in acute cases - nitrates, diuretics, positive inotropes, intra-aortic balloon pump
If in HF - ACEi + beta blockers + spironolactone
Acute, severe regurg –> surgery (repair > replacement in degenerative regurg)
If cannot repair - mechanical/pig valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What things is mitral valve prolapse associated with?

A 
PDA, ASD
Cardiomyopathy
Turner's
Marfan's, Fragile X
Osteogenesis imperfecta
Pseudoxanthoma elasticum
Wolf-Parkinson White syndrome
Long QT syndrome
EDS
PCKD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are features of mitral valve prolapse?

A

Atypical chest pain/palpitations
Mid-systolic click (occurs later if patient squatting)
Late systolic murmur (longer if pt standing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are complications of mitral valve prolapse?
MR Arrhythmias (incl. long QT) Emboli Sudden death
26
What is responsible for the first heart sound?
Closure of the mitral and tricuspid valves
27
What is responsible for the second heart sound?
Closure of aortic and pulmonary valves
28
What does splitting of S2 during inspiration indicate?
This is normal
29
When might you get a soft S1?
MR
30
When might you get a loud S1?
MS
31
When might you get a soft S1?
Aortic stenosis
32
What causes a third heart sound?
Diastolic filling of the ventricle Considered normal up to 30y (up to 50y in women) Heart in LV failure, pericarditis, MR
33
When might a fourth heart sound be heard?
AS, HOCM, HTN
34
What causes a fourth heart sound?
Atrial contraction against a stiff ventricle
35
What does a fourth heart sound coincide with on ECG?
The P wave
36
Where should you auscultate to hear the pulmonary valve?
L 2nd intercostal space, upper border of sternum
37
Where should you auscultate to hear the aortic valve?
R 2nd intercostal space, upper border of sternum
38
Where should you auscultate to hear the mitral valve?
Left fifth intercostal space, medial to midclav line
39
Where should you auscultate to hear the tricuspid valve?
Left 4th intercostal space, lower left sternal border
40
What part of the stethoscope is best at picking up high pitched noises?
Diaphragm
41
What part of the stethoscope is best at picking up low pitched noises?
Bell
42
What clinical features may be present in aortic stenosis?
Chest pain SoB Syncope
43
What murmur is classically seen in aortic stenosis?
Ejection systolic murmur
44
What decreases the murmur in aortic stenosis?
Valsalva manoeuvre
45
What are features of severe aortic stenosis?
``` Narrow pulse pressure Slow rising pulse Delayed ESM Soft/absent S2 S4 Thrill LV hypertrophy/failure ```
46
What are causes of aortic stenosis?
Degenerative calcification (most common in pts >65) Bicuspid aortic valve (most common in <65) William's syndrome (supravalvular aortic stenosis) Post-rheumatic disease Subvalvular - HOCM
47
How do you manage asymptomatic aortic stenosis?
Observe pt | Unless valvular gradient >40mmHg + features like LV systolic dysfunction
48
How do you manage symptomatic aortic stenosis?
Valve replacement
49
What treatment may be given to those with critical aortic stenosis who are not fit for valve replacement?
Balloon valvuloplasty
50
What is the murmur of AR like?
Early diastolic
51
What increases the intensity of the AR murmur?
Handgrip manoeuvre
52
What are other features of AR?
``` Collapsing pulse Wide pulse pressure Quincke sign (nailbed pulsation) De Musset's sign (head bobbing) Mid-diastolic Austin-Flint murmur in severe AR ```
53
What causes an Austin flint murmur?
Partial closure of the anterior mitral valve cusps caused by the regurg streams
54
What are causes of AR?
``` Valve dx: Rheumatic fever IE Connective tissue dx, e.g. RA/SLE Bicuspid aortic valve ``` ``` Aortic root dx: Aortic dissection Spondyloarthopathies, e.g. AS Syphillis Marfans, EDS ```
55
What are signs of tricuspid regurg?
Pansystolic murmur Promiment/giant V waves on JVP Pulsatile hepatomegaly Left parasternal heave
56
What are causes of TR?
R ventricular infarction (damage to papillary muscles) Pulmonary HTN (e.g. COPD) Rheumatic heart disease IE Ebstein's anomaly (leaflets in ventricle) Carcinoid syndrome
57
How does pulmonary hypertension cause tricuspid regurg?
It causes increased right ventricular pressure which dilates the tricuspid valve
58
What most commonly causes tricsupid valve stenosis?
Rheumatic fever (inflammation --> valve fuses)
59
What murmur do you get with tricuspid stenosis?
Mid-diastolic
60
What conditions cause an ejection systolic murmur?
Aortic stenosis Pulmonary stenosis ASD, ToF
61
What conditions cause a holosystolic murmur?
Mitral/tricuspid regurg (high pitched and blowing) | VSD (harsh in nature)
62
What conditions cause a late systolic murmur?
Mitral valve prolapse | Coarcation of aorta
63
What conditions cause an early diastolic murmur?
AR (high pitched, blowing) | Graham-Steel (pulmonary regurg, high pitched and blowing)
64
What conditions cause a mid-late diastolic murmur?
MS (rumbling) | Austin-Flint (severe AR, rumbling)
65
What condition causes a continuous machine like murmur?
PDA

CARD - 1 (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions