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Valvular Heart Disease

jennifer12345's version from 2018-09-25 00:37

Section 1

Question Answer
Grade 1barely audible
Grade 2audible but quiet and soft
Grade 3moderately loud, without a thrust or thrill
Grade 4loud, with a thrill (do not hear diastolic murmurs beyond this)
Grade 5very loud, with a thrust or thrill
Grade 6loud enough to hear without stethoscope

Section 2

Question Answer
Examples of systolic murmursaortic stenosis, mitral regurgitation, mitral valve prolapse
Examples of diastolic murmursmitral stenosis, aortic regurgitation

Section 3

Question Answer
The goal of treating valvular heart disease is to prevent endocarditisTrue
With acute mitral regurgitation cardiac output is affectedTrue
Yearly echos are not recommended for chronic mitral regurgitationFalse
the intensity of a murmur corresponds with its severity False
normal sinus rhythm on EKG does not exclude aortic stenosisTrue
Diagnosis of mitral valve prolapse is either a systolic murmur or mitral regurgitation on echoFalse
aortic regurgitation is either from deformity of the valve leaflets or dilation/dissection of aortic rootTrue
Recommend valve replacement with aortic regurgitation if EF > 55%True

Section 4

Question Answer
Acute etiologies of mitral regurgitationMI, uncontrolled HTN, infectious endocarditis
chronic etiologies of mitral regurgitationrheumatic fever, CAD, cardiomyopathy
etiology of aortic stenosisrheumatic valve, calcified valves, over age 70
etiology of mitral valve prolapseprimarily inherited, marfan's syndrome, anorexia, atrial septal defect, low body weight, low bp
etiology of mitral stenosisrheumatic heart disease, less common tumor/mass/calcifications on the valve
etiology of aortic regurgitationrheumatic fever, infectious endocarditis, trauma, inflammatory diseases, aortic dissection, HTN

Section 5

Question Answer
Symptoms of chronic mitral regurgitationprogressive dyspnea, fatigue, weakness, orthopnea
Symptoms of acute mitral regurgitationsevere orthopnea or frank pulmonary edema
Symptoms of aortic stenosisangina, dyspnea, syncope
Symptoms of mitral valve prolapseusually asymptomatic, chest pain, dyspnea, palpitations, anxiety/panic attacks
Symptoms of mitral stenosisexertional dyspnea, orthopnea, progressive fatigue and weakness
Symptoms of chronic aortic regurgitationoften none, exertional dyspnea, orthopnea, fatigue,
Symptoms of acute aortic regurgitationdyspnea, often severe and at rest, weakness

Section 6

Question Answer
sounds associated with chronic mitral regurgitationholosystolic murmur, heard best at apex, with radiation to the axilla, S3
sounds associated with acute mitral regurgitationearly systolic murmur
sounds associated with aortic stenosisejection click after S1, harsh systolic ejection murmur, parvus et tardus (carotid upstroke delayed in reaching its peak and reduced in amplitude)
sounds associated with mitral valve prolapsemidsystolic click and late systolic murmur, best heard on left decubitus position or laying down
sounds associated with mitral stenosisopening snap, loud S1, low pitched diastolic rumbling murmur
sounds associated with aortic regurgitationlong murmur with chronic, short murmur if acute

Section 7

Question Answer
Diagnostic findings of mitral regurgitationleft ventricular hypertrophy, MI, ischemia, pulm HTN, possible right heart enlarged, ST changes
Diagnostic findings of aortic stenosisleft ventricular hypertrophy, thickened immobile aortic valve on echo
Diagnostic findings of mitral valve prolapsesystolic murmor and mitral regurgitation on echo
Diagnostic findings of mitral stenosisleft atrial enlargement or atrial fibrillation, progresses to right ventricular hypertrophy
Diagnostic findings of aortic regurgitationLV hypertrophy and cardiomegaly if chronic

Section 8

Question Answer
Treatment of acute mitral regurgitationsalt restriction, diuretics, afterload reduction
Treatment of chronic mitral regurgitationsalt restriction, vasodilators (ACE-I, diuretics)
Treatment of aortic stenosissalt restriction, less strenuous activity, surgery if patient symptomatic
Treatment of mitral valve prolapsereassurance and education, beta blockers or digoxin if symptomatic
Treatment of mitral stenosismanage pulm HTN with diuretics, control afib, anticoagulation, consider mechanical interventions
Treatment of aortic regurgitationsalt restriction, avoid activity, treat HTN, reduce LV volume (vasodilators, diuretics), ?surgery

Section 9