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29 Cards in this Set
- Front
- Back
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etiologies of valvular diseas
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1 congenital- bicuspid AV
2. genetic- marfans; bicuspid AV 3. systemic inflamatory disease: rheumatic heart, syphilis etc 4. infective endocarditits, carcinoid , problems with LV |
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Recommendation for mutliple exposure to strep after Rheumatic heart disease:
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penicillin prophylaxis
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MV prolapse involvements
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annulus: dilation
leaflets: floppiness chodae: rupture |
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flail mitral leaflet
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chord ruptures and valve dips back into LA
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MVP- Valve Disorder
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connective tissue disorder
sporadic or familial benign history: click and murmur |
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sever mitral incmopetence
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holosystolic murmur; old men
LV enlargemrnt with HF symptoms, a Fib, IRREVERSIBLE LV DAMAGE MAY PRECEDE ONSET OF SYPMTOMS WITH SMI |
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MVP syndrome
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no significant mitral incompetence, slight clikc and short murmur
may be caused by autonomic dysfunction symptoms: palpitations fatigue, ex intol, benign prognosis |
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Marfan's syndrom
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AD connective tissue disorder fibrillin 1 gene (may reg. TGFB: which causes hypertrophy and fibrosis)
MVP, aortic aneurysm/dissection, aortic incompetence |
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Acute mitral regurge
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very symptomatic: pulmonary edema, low bp, fast HR
MVP can present as AMR if chord ruptures or if MI ruptures pap muscle |
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Bacterial endocarditis
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bacteria or fungi, any valve, can lead to acute regurge or chronic problem
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presentatino of a acute bacterial endocarditis
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high fever shaking chills,
ex. catheters infected with Staph Aureus |
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presentation of subacute bacterial endocard
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fatigue night sweats myalgia, weight loss,
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right sided endocarditits on the tricuspid valve
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can come from intravenous drug abuse
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functional MR
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valve ok, but ventricle not
ischemic CM- annulus dilation or pap muscle geometry change- tenting non ischemic CM- annulus dilation |
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Chronic AI causes
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abnormalities of leaflets
aortic root dilation slow massive enlargement of LV over time- MI can lead to irreversible LV failure that precedes symptoms! |
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Acute AI
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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 |
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Functional vs organic Tricuspid vlave disease
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functional: RVH or failure
organicr: rheumatic, carcinoid syndrome, trauma |
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aortic coarctation
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narrowing of descending aorta that causes HTN adn ascending aortic aneurysm
associated with bicuspid aortic valve (congenital) |
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medical management of MS
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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 |
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pulmonic valve stenosis
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more common in kids
symptoms like R sided HF Tx: percutaneous valvuloplasty |
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chronic Aortic insufficiency
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history: no sumptoms or CHF symp
physical exam: bounding pulse, blowing diastolic murmur, sit lean forward expire IRREVERSIBLE LV FAIL CAN PRECED SYMPTOMS! |
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management of chronic AI
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vasodilator: slow LV enlargement
replacemetn: symptoms or severe enlargemetn, dysfunction, or risk for dissection or rupture |
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Chronic organic Mitral Insufficiency
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physicla exam: mitrla prolapse murmur
irreversible LV Failure can precede symptoms!!! follow with echos |
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indications for Mitral valve repair/replacemetn
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HF symptoms
LV enlargement or dysfunction pulmonary HTN A Fib |
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Functional Mitral Regurge
Treatment |
standar HF treat BB ACE inhie, etc
vasodilators |
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mechanical vs tissue valves
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structural fail more likely in tissue esp in mitral position
mech valves have higher risk of bleeding bc of anti coag therapy |
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what does mid systolic click indicate?
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prolapse, mitral regurge
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holosystolic murmur,
dilated heart, S3 gallop |
Mitral regurgitation, functional or severely advanced
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history of ankylosing spondylitis, what is Dx?
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aortic insufficienty
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