Valvular Heart Disease (Johnston) Flashcards Preview

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Flashcards in Valvular Heart Disease (Johnston) Deck (23):
1

stenosis leads to __ overload while regurgitation leads to __ overload

pressure

volume

2

what happens to the LA in mitral stenosis?

Left atrium becomes enlarged and can get A fib d/t turbulence

also get pulm vascular changes, RVH

3

Ortner syndrome is hoarsenss d/t compression of the left recurrent laryngeal n. and is associated with this valvular disease:

mitral stenosis

4

what type of murmur do you hear in mitral stenosis?

Rumbling, DIASTOLIC murmur-low pitched, best heard at apex. Use the bell

5

how can you tx mitral stenosis?

anticoagulant if in A fib
percutaneous balloon valvuloplasty
MV replacement

6

what is the name of the syndrome that causes hoarseness of voice in mitral stenosis?

ortner's syndrome

7

what are 2 chronic conditions associated with mitral regurgitation?

MVP-most common etiology
Mitral annular calcification

8

what are some acute conditions associated with mitral regurg?

rupture of chord tendinae
rupture of papillary muscle
ischemic papillary muscle dysfunction

9

what type of murmur is heard in mitral regurg?

SYSTOLIC murmur --> blowing, prominent at apex, radiates into left axilla

Decreased S1, S3 gallop with radiation into left axilla

loudness of murmur correlates with severity

10

how can you tx mitral regurg?

vasodilators-Afterload reduction
decrease resistance to flow
ACEi-Chronic MR

11

describe the epidemiology of MVP:

7:1 female:male ratio
associated with Marfan's/skeletal changes

12

what type of murmur do you hear with MVP?

SYSTOLIC murmur; may have mid-systolic click

13

how can you tx MVP?

If hyper adrenergic state (anxious, palpitations), consider B blocker

14

what are some etiologies of aortic stenosis?

degenerative (calcific or senile)
congenital bicuspid aortic valve
rheumatic or post inflamm scarring

15

what is the prognosis of aortic stenosis if untreated?

without tx prognosis is poor
without tx most will die within 3 yrs of developing syncope and within 2 years of onset of HF

16

what type of murmur is heard in aortic stenosis?

SYSTOLIC murmur, HARSH, 2nd ICS RSB; radiates into suprasternal notch/carotids

17

how can you tx aortic stenosis?

percutaneous balloon valvuloplasty
temporary aortic valve replacement

18

what can aortic regurgitation be due to?

leaflet abnormalities
aortic root abnormalities (Marfans, aortic dissection, aging, HTN)

19

what are causes of acute aortic regurg?

Infectious endocarditis
aortic dissection
Bicuspid aortic valve

20

what are causes of chronic aortic regurg?

syphyllis
ankylosing spondylitis

21

what type of murmur do you hear in aortic regurg?

DIASTOLIC, decrescendo murmur, 3rd ICS LSB

this is the hallmark of aortic regurg

22

how can you tx aortic regurg?

ARB--> decrease after load to decrease regurg volume
Surgery-Aortic valve replacement when symptomatic of EF < 55%

23

De Musset sign (head bobbing) is associated with which valvular disease?

aortic regurg