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Flashcards in VALVES/MURMURS Deck (74)
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1
Q

what valvular disease causes large V waves in JVP

A

tricuspid regurgitation

2
Q

systolic thrill in aortic area

A

aortic stenosis

3
Q
pounding of heart/palpitations
angina
dyspnoea
dizziness
what valvular disease
A

aortic regurgitation

4
Q

what are the investigations for aortic stenosis

A

ECG

Echo

5
Q

machine like murmur

heard below left clavicle

A

Patent ductus arteriosus

6
Q

what is the treatment for mitral regurgitation

A

diuretics, ACEI, Digoxin, warfarin
surgery for severe - valve repair/replacement
percutaneous mitral valve repair

7
Q

when do people with valvular disease typically get symptoms

A

exertion

8
Q

what does a CXR of mitral stenosis look like

A

LA enlargement - straight left heart border

mitral valve calcification

9
Q

what would be given if there was AF with mitral stenosis

A

BB, digoxin, warfarin

10
Q

what are some s/s mitral regurgitation

A
palpitations
dyspnoea
orthopnoea
fatigue
sweating
ankle swelling
11
Q

murmur best heard at apex with patient lying on LS on expiration

A

mitral stenosis

12
Q

early diastolic murmur
high pitched and blowing murmur best heard at left sternal edge 4th ICS
with patient leaning forward and breath held in expiration

A

aortic regurgitation

13
Q

what are the different grades of valvular disease

A

1 - quiet
2/3 - loud without thrill
4/5 - loud with thrill
6 - heard without stethoscope

14
Q

presence of S4

A

aortic stenosis

15
Q

what are the 3 main causes of aortic stenosis

A

congenital abnormalities e.g. bicuspid valve
rheumatic fever
calcification

16
Q

what does mitral stenosis look like on an ECG

A

wide p waves, often bifid

17
Q

tapping apex beat

A

mitral stenosis

18
Q
palpitations
dyspnoea
orthopnoea
fatigue
sweating
ankle swelling
what valvular disease
A

mitral regurgitation

19
Q

is pulmonary regurgitation systolic or diastolic

A

diastolic

20
Q

what is the murmur the patient leans to the left for

A

mitral stenosis

21
Q

head bobbing (de mussets sign)

A

aortic regurgitation

22
Q

Loud S1, opening snap

A

mitral stenosis

23
Q

soft S1, split S2 (3rd HS)

A

mitral regurgitation

24
Q

what are some complications of mitral stenosis

A

RHF

cardiac cachexia

25
Q

what is the treatment of mitral stenosis

A

anticoagulation (risk of embolic stroke)
balloon valvotomy - if pliable valve
valve replacement
diuretics for oedema

26
Q

how do you describe a murmur

A
systolic/diastolic
type
loudest
radiate
grade
influenced by respiration
27
Q

what is the murmur the patient leans forward for

A

aortic regurgitation

28
Q

is tricuspid stenosis more common in men or women

A

women

29
Q

what are the 2 most common causes of mitral stenosis

A

rheumatic fever

congenital

30
Q

carotid pulsation (corrigans sign)

A

aortic regurgitation

31
Q

where does pulmonary stenosis radiate

A

shoulder

32
Q

what would a CXR of mitral regurgitation show

A

cardiomegaly

33
Q

harsh pan systolic murmur best heard at left sternal edge

A

ventricular septal defect

34
Q

s/s aortic regurgitation

A

pounding of heart/palpitations
angina
dyspnoea
dizziness

35
Q

do systolic or diastolic murmurs coincide with carotid pulse

A

systolic

36
Q

heaving apex beat, undisplaced

A

aortic stenosis

37
Q

LA enlargement - straight left heart border
mitral valve calcification
CXR showing what?

A

mitral stenosis

38
Q

malar flush

A

mitral stenosis

39
Q

what is the treatment of aortic stenosis

A

surgery

valve replacement/transcatheter aortic valve implantation

40
Q

early diastolic murmur

A

aortic regurgitation

41
Q

slow rising pulse

A

aortic stenosis

42
Q

soft/absent S2

A

aortic stenosis

43
Q

what murmurs are louder on inspiration

A

right sided

44
Q

what are 2 complications of aortic stenosis

A

cardiac arrest

HF

45
Q

what murmurs are systolic

A

MRS ASS
Mitral regurgitation
aortic stenosis

46
Q

bounding / collapsing pulse

A

aortic regurgitation

47
Q

how can an MI cause mitral regurgitation

A

rupture/dysfunction of chordae tendinae / papillary muscles

48
Q

radiates to carotids and precordium

A

aortic stenosis

49
Q

jerky pulse

A

mitral regurgitation

50
Q

what are the most common valve diseases secondary to HF and why

A

tricuspid/mitral regurgitation

enlarged ventricles cause incomplete seal at valves

51
Q

rumbling mid diastolic murmur

A

mitral stenosis

52
Q

does tricuspid regurgitation radiate

A

no

53
Q

what is the treatment of aortic regurgitation

A

treat underlying disease e.g. endocarditis
valve replacement
ACEIs, ARBs, Diuretics

54
Q

is pulmonary stenosis systolic or diastolic

A

systolic

55
Q

low volume pulse

A

aortic stenosis

mitral stenosis

56
Q

what qualifies as an innocent murmur

A

systolic
pulmonary area
no other cardiac problems

57
Q

what would mixed aortic valve disease show

A

pluses biferens

58
Q

apex beat laterally displaced and downwards and is forceful in quality

A

aortic regurgitation

59
Q

capillary pulsation in nail bed (quinckies sign)

A

aortic regurgitation

60
Q

s/s mitral stenosis

A

breathless
tiredness
palpitations
MALAR FLUSH

61
Q

Pan-systolic murmur

A

mitral regurgitation

62
Q

crescendo decresendo murmur

A

aortic stenosis

63
Q

systolic thrill

A

mitral regurgitation

aortic stenosis

64
Q

Pan-systolic murmur
high pitched and blowing murmur that radiates over precordium to left axilla
loudest at apex beat

A

mitral regurgitation

65
Q

what are 5 causes of mitral regurgitation

A
rheumatic fever
MV calcification
DCM/HCM
endocarditis
MI
66
Q

high volume pulse, displaced apex

A

aortic regurgitation

mitral regurgitation

67
Q

wide pulse pressure

A

aortic regurgitation

68
Q

what are 4 causes of aortic regurgitation

A

rheumatic fever
IEC
hypertension
marfans/AAD

69
Q

ejection systolic murmur

A

aortic stenosis

70
Q

s/s aortic stenosis

A

syncope/presyncope
angina
dyspnoea

71
Q

narrow pulse pressure

A

aortic stenosis

72
Q

pulsatile hepatomegaly

A

tricuspid regurgitation

73
Q
hepatomegaly 
ascites
abdominal pain
dependent oedema
what is the valvular disease
A

tricuspid stenosis

74
Q

A jerky pulse, double apex beat and an ejection systolic murmur is associated with what

A

HCM