Valvular Heart Disease Flashcards Preview

Nayla Foundations > Valvular Heart Disease > Flashcards

Flashcards in Valvular Heart Disease Deck (81)
Loading flashcards...
1

What do stenotic lesions lead to

pressure overload on upstream

2

What do regurgitant lesions lead to

Volume overload and dilation of chambers

3

What is Diastolic dysfunction

The inability of ventricle to relax/decreased wall compliance limiting filling during early passive diastole. Atria has to contract harder to get blood out

4

What does diastolic dysfunction lead to

Pressure in atria rises and backs up to the lungs- Pulmonary edema
Also- atrial arrhythmias

5

What are causes of LV diastolic dysfunction

HTN
VH
fibrosis
Infiltrative CM
Pericardial constriction

6

What are causes of RV diastolic dysfunction

rare
constrictive pericarditis
restrictive cardiomyopathy

7

What do right murmurs do

increase with inspiration

8

What are left HF symptoms

dyspnea
pulmonary edema
crackles
PE
pallor/cyanosis

9

What are right HF symptoms

JVD
peripheral edema
Hepatomegaly
ascites

10

How can you grade a murmur

I: heard in quiet room by expert
VI: thrill with very loud murmur without steth

11

What murmurs warrant an echo

Systolic > grade II
any diastolic

12

What is the most common cause of aortic stenosis

calcified valve

13

What is the compensatory response to aortic stenosis

LVH, more pressure needed to overcome rigid valve.
Reduced EF
LA hypertrophy

14

What is the classic triad associated with aortic stenosis

Angina
Syncope
Heart failure

15

What are characteristics of aortic stenosis on exam

Delayed carotid upstroke
Sustained, diffuse apical impulse
Systolic murmur at RUSB, crescendo-decrescendo, radiating to neck

16

How should you treat a patient with severe AS that is not a surgical candidate

TAVR or medical therapy to control HF

17

What diagnostic test is contraindicated in AS

exercise stress test

18

What surgical treatments are available for AS patients

#1: Mechanical or tissue valve replacement
-Balloon valvuloplasty for peds, or as a bridge for adults (will restenose in 6 mo.)

19

What are the types of valves

Bioprosthetic: shorter lifespan (10-15 years)
Mechanical: lifelong anti-coag (warfarin) needed

20

What are the biggest issues with a TAVR

CVA
Complete heart block
paravalvular leak

21

What are the causes of aortic regurgitation

abnormalities of leaflets/aortic root
chronically progresses slowly over 10 years until LV dysfunction

22

What is the #1 cause of acute aortic regurgitation

Aortic Dissection
(also endocarditis)

23

What happens during chronic AR

-Increased LV EDV
-Increased wall stress causes LVH
-CO initially increased but decreases as disease progresses and aorta is less compliant

24

What will you see on PE for chronic AR

-Water hammer pulse
-Blowing Diastolic Decrescendo Murmur at LUSB
-Signs of left HF

25

What can you see on chronic AR CXR

Aortic knob, cardiomegaly

26

Who is a candidate for surgical treatment for chronic AR

Symptomatic
ASx but having heart surgery
LV dysfunction
Aortic root dilation >5 cm (less for marfans)

27

What should nonsurgical candidates with chronic AR do

Take vasodilators, CCB, ACE
BB for aortic root enlargement

28

What is the cause of chronic aortic regurgitation

aortic root disease

29

What is dangerous with acute AR

no time to develop compensatory mechanisms; Hemodynamic emergency
Leads to cardiovascular decompensation

30

What are symptoms of acute aortic regurg

weakness, AMS, dyspnea, syncope
**CP=Aortic dissection