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Flashcards in Valvular heart disease - lecture Deck (29):
1

Signs of right heart failure

Raised JVP
Pitting oedema
Hepatic congestion

2

Where is the apex beat normally?

5th intercostal space, mid clavicular line

3

When might you feel a tapping apex?

Mitral stenosis

4

When might you feel a parasternal heave?

Right ventricular overload

5

When might the apex beat be displaced?

In left ventricular dilatation or left ventricular hypertrophy

6

Where would you auscultate the aortic valve?

2nd -3rd right interspace

7

Where would you auscultate the pulmonary valve?

2nd-3rd LEFT interspace

8

Where would you auscultate the tricuspid valve?

Left sternal border

9

Where would you auscultate the mitral valve?

Apex

10

What is the first heart sound

The mitral and tricuspid valve closing - start of systole

11

What is the second heart sound?

Aortic and pulmonary valve closing - start of diastole

12

Where does aortic stenosis radiate to?

Carotids

13

Where does mitral regurgitation radiate to?

Axilla

14

Are right or left sided murmurs louder with inspiration?

Right sided murmurs are louder with inspiration

15

Which type of murmurs are always pathological?

Diastolic murmurs

16

Low volume pulse
Forceful displaced apex
Ejection systolic murmur that can radiate to carotids

Aortic stenosis

17

Treatment for aortic stenosis

Conventional valve replacement (preferred)
Trans catheter aortic valve replacement
Balloon aortic valve replacement

18

Who would you give mechanical valves to? Why might you not give mechanical valve?

Give to longer patients as last longer, but have to give warfarin

19

Who would you give bioprosthetic valves to?

Give to older people, last ten years.
Don't have to give warfarin

20

Displaced apex
Pansystolic murmur that radiates to axilla

Mitral regurgitation

21

Treatment for mitral regurgitation

Diuretics and ACE inhibitors for heart failure

22

How would you treat a prolapsed valve and how would you treat a degenerative valve?

Prolapsed - repair
Degenerative - fix

23

Malar flush
Tapping apex beat
Mid diastolic rumbling diastolic murmur localised to apex

Mitral stenosis

24

Straight left heart border

Mitral stenosis

25

What is a collapsing pulse associated with?

Aortic regurgitation

26

Collapsing pulse
Wide pulse pressure
Displaced apex

Aortic regurgitation

27

Narrow pulse pressure

Aortic stenosis

28

Wide pulse pressure

Aortic regurgitation

29

Where would you hear the murmur of aortic regurgitation

Left sternal edge