VHD and murmurs pt 2 highlights Flashcards
(17 cards)
Give 2 examples of widened pulse pressure and define them
1) Corrigan pulse = “water hammer pulse”
2) Quincke pulse = visualization of pulse over the nail beds during light pressure to distal nail bed
When is the AR murmur heard best?
At Erb’s point – 3rd ICS, sitting up and leaning forward, during exhalation
AR: __________________ murmur may be appreciated; a mid diastolic rumble murmur heard best at apex
Austin-Flint
MS murmur is heard best at apex with patient lying in what position?
left lateral recumbency
With MS, there’s an ______________ followed by a ___________________________ murmur just after S2 (similar timing as S3)
opening snap; low pitched rumbling diastolic
1) EKG with MS may show LAE (P mitrale); LAE increases risk of _____________
2) LAE may result in ______________; esophagus runs posterior to LA in mediastinum
1) A. Fib
2) dysphagia
What do MS and AR have in common?
Diastolic murmurs
Differentiate MS and AR (short version)
1) MS = after S2, low pitched, rumbling, apex with patient in LL position
2) AR = begins at S2, blowing, high pitched,
Scarlet fever and cause what?
Mitral regurg
What type of AC can be used in pregnancy??
LWMH
Who requires lifelong coag? Who doesn’t?
1) Mechanical: Lifelong anticoagulation
2) Bioprosthetic: ~3 months anticoag
What do both mechanical and bioprosthetic valves have in common?
Both need Antibiotic prophylaxis before some surgical or dental procedures to prevent endocarditis
Can you play contact sports on anticoags?
No
Competitive sports: Sports classified as _____________ or ______________demands are NOT recommended with anticoags
high dynamic; high static
Antimicrobial prophy recommended with single dose of_________________ or suitable alternative (Sanford Guide) for prosthetic valves 1 hour prior to dental procedures
2 gm amoxicillin
PHV and thromboembolism: Incidence ~ 6% per year with mechanical, rare with _______________ heart valve
bioprosthetic
PHV and thromboembolism: Most TE events related to ___________________ dosing
subtherapeutic
