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29 Cards in this Set

  • Front
  • Back
etiologies of valvular diseas
1 congenital- bicuspid AV
2. genetic- marfans; bicuspid AV
3. systemic inflamatory disease: rheumatic heart, syphilis etc
4. infective endocarditits, carcinoid , problems with LV
Recommendation for mutliple exposure to strep after Rheumatic heart disease:
penicillin prophylaxis
MV prolapse involvements
annulus: dilation
leaflets: floppiness
chodae: rupture
flail mitral leaflet
chord ruptures and valve dips back into LA
MVP- Valve Disorder
connective tissue disorder
sporadic or familial
benign history: click and murmur
sever mitral incmopetence
holosystolic murmur; old men
LV enlargemrnt with HF symptoms, a Fib,
IRREVERSIBLE LV DAMAGE MAY PRECEDE ONSET OF SYPMTOMS WITH SMI
MVP syndrome
no significant mitral incompetence, slight clikc and short murmur
may be caused by autonomic dysfunction
symptoms: palpitations fatigue, ex intol, benign prognosis
Marfan's syndrom
AD connective tissue disorder fibrillin 1 gene (may reg. TGFB: which causes hypertrophy and fibrosis)

MVP, aortic aneurysm/dissection, aortic incompetence
Acute mitral regurge
very symptomatic: pulmonary edema, low bp, fast HR

MVP can present as AMR if chord ruptures or if MI ruptures pap muscle
Bacterial endocarditis
bacteria or fungi, any valve, can lead to acute regurge or chronic problem
presentatino of a acute bacterial endocarditis
high fever shaking chills,
ex. catheters infected with Staph Aureus
presentation of subacute bacterial endocard
fatigue night sweats myalgia, weight loss,
right sided endocarditits on the tricuspid valve
can come from intravenous drug abuse
functional MR
valve ok, but ventricle not
ischemic CM- annulus dilation or pap muscle geometry change- tenting
non ischemic CM- annulus dilation
Chronic AI causes
abnormalities of leaflets
aortic root dilation
slow massive enlargement of LV over time- MI can lead to irreversible LV failure that precedes symptoms!
Acute AI
cause by endocard or aortic dissection
pulm edema SOB, fever chills weight loss; tearing chest pain for disscection
Dx based on echo
urgernt surgical valve replacement
Functional vs organic Tricuspid vlave disease
functional: RVH or failure
organicr: rheumatic, carcinoid syndrome, trauma
aortic coarctation
narrowing of descending aorta that causes HTN adn ascending aortic aneurysm
associated with bicuspid aortic valve (congenital)
medical management of MS
anitbiotic prophylaxis
beta blocker to slow HR- increse diastolic filling (esp imp for exer and a fib)
anticoag when history of a fib or stroke
pulmonic valve stenosis
more common in kids
symptoms like R sided HF
Tx: percutaneous valvuloplasty
chronic Aortic insufficiency
history: no sumptoms or CHF symp
physical exam: bounding pulse, blowing diastolic murmur, sit lean forward expire
IRREVERSIBLE LV FAIL CAN PRECED SYMPTOMS!
management of chronic AI
vasodilator: slow LV enlargement
replacemetn: symptoms or severe enlargemetn, dysfunction, or risk for dissection or rupture
Chronic organic Mitral Insufficiency
physicla exam: mitrla prolapse murmur
irreversible LV Failure can precede symptoms!!! follow with echos
indications for Mitral valve repair/replacemetn
HF symptoms
LV enlargement or dysfunction
pulmonary HTN
A Fib
Functional Mitral Regurge
Treatment
standar HF treat BB ACE inhie, etc
vasodilators
mechanical vs tissue valves
structural fail more likely in tissue esp in mitral position
mech valves have higher risk of bleeding bc of anti coag therapy
what does mid systolic click indicate?
prolapse, mitral regurge
holosystolic murmur,
dilated heart,
S3 gallop
Mitral regurgitation, functional or severely advanced
history of ankylosing spondylitis, what is Dx?
aortic insufficienty