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Flashcards in Valvular Heart Dz Deck (27)
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1
Q

What is the most common cause of VHD?

A

myxomatous degeneration

congenital (bicuspid aortic valve)

2
Q

What do stenosis and regurgitation cause to the heart?

A

stenosis –> pressure overload, hypertrophy and HF

regurgitation –> volume overload; dilates

3
Q

When are diastolic murmors heard?

A

after S2 and before the next S1

4
Q

What murmors are systolic (6)?

A

MR (mitral regurg)

TR (tricuspid regurg)

AS (aortic stenosis)

PS (pulmonic stenosis)

VSD

ASD

5
Q

Which murmurs are diastolic?

A

AI or AR (Aortic Insufficiency or Regurg)

PI or PR (Pul insufficiency or regurg)

MS (mitral stenosis)

TS (tricuspid stenosis)

Atrial myxoma

6
Q

At what murmur grade is there a palpable thrill?

A

4/6

7
Q

What type of murmur are MR and TR?

What about MS and TS?

A

regurg: systolic
stenosis: diastolic

8
Q

What type of murmur are AS and PS?

What about AR and PR?

A

Atrial/ pulmonary stenosis = systolic

regurg = diastolic

9
Q

Where do you hear mitral regurg the best?

A

blowing at apex, radiates into left axilla

10
Q

Where is mitral valve prolapse heard best?

A

apex

(mid-systolic click)

11
Q

What causes MVP murmur to increase?

A

valsalva and standing

12
Q

What action causes tricuspic regurg to increase in sound?

A

inspiration (Carvallo sign, also seen in TS)

13
Q

How does the jungular venous pulse change in tricuspid regurg?

A

prominent V wave

14
Q

Where do you hear AS?

A

right 2nd ICS –> radiates into sternal notch/carotids

15
Q

How does AS affect S1 and S2?

A

diminished S2

16
Q

What is the pulse pressure like in AS?

A

narrow (140/100)

17
Q

What do you see on ECG in AS?

A

strain pattern = down sloping of ST segment - T wave

18
Q

What does VSD sound like and where?

A

holosystolic

left lower sternal border w/ thrill

increases w/ handgrip

19
Q

What characterizes ASD murmur?

A

systolic

upper LSB w/ fixed splitting of S2

20
Q

How should you listen to a mitral stenosis murmur?

A

use bell bc low pitch

21
Q

What does MS sound like?

A

the Operating System is MicroSoft

rumbling at apex

inc S1 and S2 –> opening snap

22
Q

What is a carvallo sign?

A

murmur increases on inspiration

(seen in TS and TR)

23
Q

What is DeMusset sign?

A

head bob with beats

seen in AR

24
Q

What is Quincke’s sign?

A

capillary nail pulsations

seen in AR

25
Q

What is Traube sign?

A

pistol shot (systolic and diastolic) sounds over femoral A

26
Q

What is duroziez’s sign?

A

diastolic murmor over femoral A when compressed w/ bell of stethoscope

seen in AR

27
Q

What does PR murmur sound like?

A

diastolic, decrescendo murmur

increased S2