vascular Flashcards

(33 cards)

1
Q

what are chordae tendineae

A

Fibrous tissue that anchor valve leaflets to papillary muscles of the ventricles

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2
Q

what is regurgitation

A

When valves do not close completely when they are supposed to close

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3
Q

what is stenosis

A

When valves do not open completely when they are supposed to open

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4
Q

what is the difference in the mitral valves?

A

The anterior leaflet is longer

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5
Q

what happens in mitral valve prolapse

A

A portion of one or both mitral valve leaflets balloons back into the atrium during systole leading to regurgitation

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6
Q

what heart sound can be heard in patients with mitral valve prolapse

A

Extra heart sound: mitral click

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7
Q

what are patients with mitral valve prolapse at increased risk for

A

Endocarditis

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8
Q

What antibiotic prophylaxis is recommended for high-risk patients before and after dental procedures?

A

amoxicillin

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9
Q

what can cause mitral regurgitation?

A

Thickness and fibrosis of the chordae tendineae → they pull on the leaflet so it can’t close
Developing countries: rheumatic heart disease
Developed countries: degenerative changes of the mitral valve

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10
Q

what are the symptoms of mitral regurgitation

A

Dyspnea, fatigue, weakness, clots, stroke

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11
Q

what kind of murmur does mitral regurgitation cause

A

High-pitched blowing sound at the apex on systole

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12
Q

what is the treatment for mitral regurgitation

A

Reduce afterload (same for HF)

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13
Q

what causes mitral stenosis

A

Obstruction of the blood flowing from the left atrium to the left ventricle due to the narrowing of the mitral valve orifice

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14
Q

what are the symptoms of mitral stenosis

A

low-key everything?
enlarged left atrium → dry cough wheezing and afib, hemoptysis, palpitations, orthopnea, paroxysmal nocturnal dyspnea, repeated infections

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15
Q

what kind of murmur does mitral stenosis have

A

low pitched rumbling diastolic

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16
Q

what is the surgical intervention for mitral stenosis

A

Percutaneous transluminal balloon valvuloplasty → child-bearing aged women

17
Q

what causes aortic regurgitation

A

flow of blood back into the left ventricle from the aorta during diastole

18
Q

what are the symptoms of aortic regurgitation

A

Marked arterial pulsations visible or palpable at carotid or temporal arteries
Forceful heartbeat especially in head or neck

19
Q

what kind of murmur does aortic regurgitation have

A

High-pitched, blowing diastolic murmur at the third or fourth intercostal space at the left sternal border

20
Q

what happens to the blood pressure of a patient with aortic regurgitation

A

widened pulse pressure

21
Q

what is the medical management of aortic regurgitation

A

Afterload reduction, sodium restriction, and avoid fluid overload

22
Q

when would surgical management be recommended for a patient with aortic regurgitation

A

left ventricular dilation

23
Q

what kind of murmur does aortic stenosis have

A

Loud, harsh systolic murmur heard over the aortic area and may radiate to the carotid arteries and apex of the carotid arteries and apex of the left ventricle
Low-pitched, crescendo-decrescendo, rough, rasping, and vibrating

24
Q

what is the prevention for aortic stenosis

A

control risk factors for proliferative and inflammatory responses

25
what are the types of valvuloplasty
commissurotomy, closed, open, annuloplasty, and leaflet repair
26
what is commissurotomy
procedure performed to separate the fused leaflets
27
what is closed valvuloplasty and who is it beneficial for
Balloon valvuloplasty → younger patients with mitral valve stenosis
28
What are the contraindications for a closed valvuloplasty?
Left atrial or ventricular thrombus, severe valvular calcifications, thoracolumbar scoliosis, rotation of the great vessels, open heart surgery
29
what is annuloplasty
repair of the valve annulus
30
what are the types of leaflets repair
Elongated: folded over onto itself and suture Short leaflets: chordoplasty (repair of the chordae tendineae) Holes: pericardial or synthetic patch may be used
31
what is the easiest valve to repair
Mitral valve, the rest should be replaced instead → aortic has a 50% restenosis 6 months later
32
what are the complications of a mitral balloon valvuloplasty
mitral regurgitation, bleeding from insertion site, emboli, ventricular perforation,
33
what are the two types of valve replacements
mechanical More durable Less likely to be infected Need anticoagulants Tissue - Bioprosthesis: from pigs, cows, or horses - Homografts: human valves - Autografts: patient’s own pulmonic valve - Less likely to generate thromboemboli and long- term anticoagulation is not required