Flashcards in Valvular heart disease - lecture Deck (29):
Signs of right heart failure
Where is the apex beat normally?
5th intercostal space, mid clavicular line
When might you feel a tapping apex?
When might you feel a parasternal heave?
Right ventricular overload
When might the apex beat be displaced?
In left ventricular dilatation or left ventricular hypertrophy
Where would you auscultate the aortic valve?
2nd -3rd right interspace
Where would you auscultate the pulmonary valve?
2nd-3rd LEFT interspace
Where would you auscultate the tricuspid valve?
Left sternal border
Where would you auscultate the mitral valve?
What is the first heart sound
The mitral and tricuspid valve closing - start of systole
What is the second heart sound?
Aortic and pulmonary valve closing - start of diastole
Where does aortic stenosis radiate to?
Where does mitral regurgitation radiate to?
Are right or left sided murmurs louder with inspiration?
Right sided murmurs are louder with inspiration
Which type of murmurs are always pathological?
Low volume pulse
Forceful displaced apex
Ejection systolic murmur that can radiate to carotids
Treatment for aortic stenosis
Conventional valve replacement (preferred)
Trans catheter aortic valve replacement
Balloon aortic valve replacement
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
Who would you give bioprosthetic valves to?
Give to older people, last ten years.
Don't have to give warfarin
Pansystolic murmur that radiates to axilla
Treatment for mitral regurgitation
Diuretics and ACE inhibitors for heart failure
How would you treat a prolapsed valve and how would you treat a degenerative valve?
Prolapsed - repair
Degenerative - fix
Tapping apex beat
Mid diastolic rumbling diastolic murmur localised to apex
Straight left heart border
What is a collapsing pulse associated with?
Wide pulse pressure
Narrow pulse pressure
Wide pulse pressure