Valvular Heart Dx

Question 1

What are valvular heart diseases?

Answer 1

Conditions affecting the heart valves, leading to stenosis or regurgitation, affecting blood flow and cardiac function.

Question 2

What are the four heart valves?

Answer 2

Tricuspid, pulmonary, mitral, and aortic valves.

Question 3

What is aortic stenosis?

Answer 3

Obstruction of blood flow across the aortic valve due to narrowing or calcification.

Question 4

What is the most common cause of aortic stenosis in adults?

Answer 4

Age-related degenerative calcific aortic stenosis (senile sclerosis).

Question 5

What are the three classic symptoms of aortic stenosis?

Answer 5

Angina, syncope, and heart failure (dyspnea on exertion).

Question 6

What is the classic murmur of aortic stenosis?

Answer 6

Ejection systolic murmur, loudest at the right 2nd intercostal space, radiating to the carotids.

Question 7

What is aortic regurgitation?

Answer 7

Backward flow of blood from the aorta into the left ventricle during diastole.

Question 8

What are some causes of aortic regurgitation?

Answer 8

Bicuspid valve, Marfan syndrome, aortic dissection, infective endocarditis, rheumatic disease.

Question 9

What is the Austin Flint murmur?

Answer 9

A low-pitched mid-diastolic murmur heard in aortic regurgitation due to blood jet striking the mitral valve leaflet.

Question 10

What is widened pulse pressure, and what condition is it associated with?

Answer 10

Increased systolic with decreased diastolic pressure; seen in aortic regurgitation.

Question 11

What is mitral stenosis?

Answer 11

Obstruction of blood flow from the left atrium to the left ventricle due to mitral valve narrowing.

Question 12

What is the most common cause of mitral stenosis?

Answer 12

Rheumatic heart disease.

Question 13

What are the auscultatory findings in mitral stenosis?

Answer 13

Loud S1, opening snap after S2, and diastolic rumbling murmur best heard at the apex.

Question 14

What is the effect of mitral stenosis on the left atrium?

Answer 14

Leads to left atrial enlargement and atrial fibrillation.

Question 15

What is mitral regurgitation?

Answer 15

Abnormal backflow of blood from the left ventricle into the left atrium during systole.

Question 16

What are common causes of mitral regurgitation?

Answer 16

Mitral valve prolapse, rheumatic heart disease, infective endocarditis, ischemic heart disease.

Question 17

What is the characteristic murmur of mitral regurgitation?

Answer 17

Pansystolic (holosystolic) murmur best heard at the apex, radiating to the axilla.

Question 18

What auscultatory finding is common in acute mitral regurgitation?

Answer 18

Diminished S1 due to rapid valve closure.

Question 19

What is the significance of S3 in mitral regurgitation?

Answer 19

Indicates volume overload and left ventricular dysfunction.

Question 20

What is the primary imaging modality for valvular heart disease?

Answer 20

Echocardiography.

Question 21

What is the primary treatment for symptomatic severe aortic stenosis?

Answer 21

Aortic valve replacement (surgical or transcatheter).

Question 22

What are the indications for aortic valve replacement?

Answer 22

Severe symptomatic aortic stenosis or left ventricular dysfunction.

Question 23

What is the primary treatment for mitral stenosis?

Answer 23

Percutaneous balloon mitral valvotomy (PBMV) or valve replacement.

Question 24

What is the primary treatment for mitral regurgitation?

Answer 24

Mitral valve repair or replacement in symptomatic patients.

Question 25

What is the major risk associated with untreated mitral stenosis?

Answer 25

Atrial fibrillation and thromboembolism (stroke).

Question 26

What is the effect of aortic regurgitation on the left ventricle?

Answer 26

Leads to left ventricular dilation and hypertrophy due to volume overload.

Question 27

What is the effect of mitral stenosis on pulmonary circulation?

Answer 27

Pulmonary hypertension due to increased left atrial pressure.

Question 28

What is the classic pulse finding in aortic regurgitation?

Answer 28

Bounding and collapsing pulse (Corrigan's pulse).

Question 29

What is De Musset’s sign?

Answer 29

Head bobbing with each systolic pulse, seen in aortic regurgitation.

Question 30

What is Traube’s sign?

Answer 30

Pistol-shot sound heard over the femoral arteries in aortic regurgitation.

Question 31

What is Duroziez’s sign?

Answer 31

Systolic murmur over the femoral artery with proximal compression and diastolic murmur with distal compression.

Question 32

What is the most common valvular disease in developed countries?

Answer 32

Aortic stenosis due to degenerative calcification.

Question 33

What is the first heart sound (S1) like in mitral stenosis?

Answer 33

Loud due to delayed closure of the mitral valve.

Question 34

What is the typical appearance of mitral stenosis on echocardiography?

Answer 34

Thickened mitral leaflets with restricted opening and 'hockey-stick' appearance.

Question 35

What is the impact of mitral regurgitation on the left atrium?

Answer 35

Left atrial dilation due to volume overload.

Question 36

What maneuver increases the murmur intensity of mitral regurgitation?

Answer 36

Handgrip maneuver (increases afterload).

Question 37

What maneuver increases the murmur intensity of aortic stenosis?

Answer 37

Squatting (increases preload and afterload).

Question 38

What is the primary cause of aortic regurgitation in developing countries?

Answer 38

Rheumatic heart disease.

Question 39

What is the preferred valve replacement for younger patients?

Answer 39

Mechanical valves due to durability.

Question 40

What is the main disadvantage of mechanical heart valves?

Answer 40

Require lifelong anticoagulation with warfarin.

Question 41

What is the advantage of bioprosthetic valves?

Answer 41

Do not require lifelong anticoagulation but have limited durability.

Question 42

What is the most common cause of tricuspid regurgitation?

Answer 42

Right ventricular dilation secondary to pulmonary hypertension.

Question 43

What is the best auscultatory location for tricuspid regurgitation?

Answer 43

Lower left sternal border.

Question 44

What is the best auscultatory location for pulmonary stenosis?

Answer 44

Left upper sternal border.

Question 45

What is the first-line imaging for diagnosing valvular abnormalities?

Answer 45

Transthoracic echocardiography (TTE).

Question 46

What is the definitive treatment for symptomatic severe tricuspid regurgitation?

Answer 46

Tricuspid valve repair or replacement.

Question 47

What is the effect of pulmonary stenosis on the right ventricle?

Answer 47

Right ventricular hypertrophy due to pressure overload.

Question 48

What is the characteristic murmur of pulmonary stenosis?

Answer 48

Harsh systolic murmur at the left upper sternal border with an ejection click.

Question 49

What is the characteristic murmur of tricuspid regurgitation?

Answer 49

Holosystolic murmur at the lower left sternal border, increasing with inspiration.

Question 50

What is the common cause of pulmonary regurgitation?

Answer 50

Pulmonary hypertension or previous surgical repair of tetralogy of Fallot.

Question 51

What is the impact of aortic stenosis on stroke volume?

Answer 51

Decreased stroke volume due to outflow obstruction.

Question 52

What is the primary indication for percutaneous balloon valvuloplasty?

Answer 52

Severe mitral stenosis in patients without contraindications.

Question 53

What arrhythmia is most associated with mitral stenosis?

Answer 53

Atrial fibrillation.

Question 54

What is the gold standard test for assessing valvular abnormalities?

Answer 54

Echocardiography with Doppler imaging.