52 - murmur Flashcards Preview

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Flashcards in 52 - murmur Deck (40)
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1
Q

what is the 1st heart sound

A

closing tricuspid / mitral

2
Q

Systolic murmurs

A

Aortic and pulmonary stenosis. AV regurg.

3
Q

Diastolic murmurs

A

Aortic and pulmonary regurg. AV stenosis

4
Q

murmur in hypertrophic cardiomyopathy

A

systolic murmur heard best at lower sternal border. Valsalva increases venous return and makes the murmur louder.

5
Q

murmur in PDA

A

Continuous machinery murmur radiating to back.

6
Q

3 basic Ix for murmur with Sx

A

ECG, CXR, ECHO

7
Q

Causes of AS

A

congenital, rheumatic fever, aging, atherosclerosis

8
Q

Rfs for AS

A

smoking HTN, cholesterol, diabetes,

9
Q

Drugs CI in AS

A

Beta blockers, Ace inhibitors and nitroglycerin

10
Q

Signs of AS

A

Orthopnea, PND, swollen legs, pallor, flushing, slow rising pulse

11
Q

Bicuspid AV murmer heard where? Other sign on examination

A

murmur at right 2nd intercostal space. May have differences in blood pressure between arms and legs.

12
Q

AR sx

A

breathlessness on exertion, orthopnea, angina, cyanosis, palpitations, PND.

13
Q

Hypertrophy where in AS

A

LV

14
Q

Cause od AR

A

Most cases are idiopathic. Known to be associated with aging, syphilis, Marfans, Ehler-Danlos, Behcets and other seronegative diseases

15
Q

Mx of AR

A

If disease is stable, treat with ACE inhibitors to decrease afterload.

Surgery reserved for severe disease as is an open heart procedure.

16
Q

Usual cause of PS

A

Congenital

17
Q

Mx of PS

A

Replacement / balloon valvuloplasty

18
Q

PR causes

A

pulmonary hypertension, Tetralogy of Fallot, rheumatic fever, endocarditis, Ehler-Danlos, Marfans,

19
Q

What does PR ->?

A

Right heart failure and diastolic murmur ]

RVH

20
Q

MS sx

A

Chest pain, palpitations, haemoptysis, weakness, malar flash and fatigue.

21
Q

Ms -> ?

A

heart failure with dyspnoea, ascites and oedema

22
Q

Mx of symptomatic MS

A

valve replacement/balloon dilation. Manage symptoms (i.e. angina with GTN etc.)

23
Q

Usual cause of MS

A

Rheumatic fever

24
Q

What happens in mitral insufficiency / prolapse

A

Mitral valve not fully patent or does not closed properly. Blood flows backwards into the left atrium.

25
Q

Signs of Mitral insufficiency

A

signs of congestive heart failure: SOB at rest, orthopnea, PND, pulmonary oedema, tachycardia.

Pansystolic murmur and a 3rd heart sound.

Prolapse produces a systolic click.

26
Q

What may mitral insufficiency ->

A

cardiogenic shock

AF

27
Q

Causes of mitral insufficiency

A

post-MI, rheumatic fever, Ehler-Danlos, Marfans, endocarditis (most common),

28
Q

Tricuspid regurge signs

A

Produces a right sided heart failure: ascites, peripheral oedema.

Third heart sound and pansystolic murmur.

Liver may be pulsatile.

RVH

29
Q

Causes of tricuspid regurge

A

pulmonary hypertension, rheumatic fever, endocarditis, Ebstein anomaly, MI, chronic lung disease,

30
Q

Mx of TR

A

Manage heart failure with ACE inhibitors and suitable diuretics

31
Q

TS cause and always with?

A

caused by rheumatic fever and accompanied by mitral valve disease.

32
Q

prophylaxis in valvular heart disease? Who wlse gets this?

A

Against infective endocarditis (S aureus and viridans most common)

Oral health is important.

Amoxicillin 2g PO. Prior to surgical and dental procedures.

Also applies to those with Hypertrophic cardiomegally,

PMHx of endocarditis and those with prosthetic valves or transplants.

33
Q

Signs of cyanotic heart disease

A

Clubbing, cyanosis, crouching posture, crying, rapid breathing and heart rate, delayed development.

34
Q

Sx of PDA

A

raised WOB, failure to thrive, CHF, machinery murmur, cardiomegaly, tachycardia, cyanosis,

35
Q

Mx of PDA

A

NSAIDs

if fail - percutaneous surgery

36
Q

When would you not treat PDA

A

If great vessels are transposed, this needs to remain patent; prostaglandins given until corrective surgery has been provided.

37
Q

What happens in coarctation of the aorta?

A

Aorta narrows around the ductus arteriosus.

Causes left ventricular hypertrophy to compensate.

38
Q

What is marfans ? phenotype?

A

Connective tissue disorder.
Autosomal dominant.

Phenotype of a tall thin, long limbed person. Increased risk of scoliosis and joint flexiblity. Other abnormalities: pectus excavatum, flat feet, hammer toes, arched palate,

Thumb sign and other Ghent criteria

39
Q

Marfans complications

A

Mitral valve prolapse, aneurysms, osteoarthritis, GORD, aortic dissection, pneumothorax,

40
Q

Mx of Marfans

A

No cure.
Requires regular cardio check ups.

Beta blockers (metoprolol) and losartan

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