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14 Cards in this Set

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Aortic stenosis... classic signs/symptoms.

hemoptysis (bleeding from lungs) acute rheumatic fever, growing pains, rashes (erythema marginatum), skin nodules....dyspnea, orthopnea, PND.

what would you see on an ECG in aortic stenosis, murmur you would see?

tests you would order?

loud S1, also loud opening snap right after S2. prolonged P-R since ventricle taking longer to fill,

you would see a prolonged DIASTOLIC LOW RUMBLE murmur

ECG, CXR, US

what happens to valve in aortic stenosis? LA? RV? consequences

do you see LV problems?

gets stiff and calcified...dont hear sound if too calcifies. LA gets dilated --> arrhytmias

RV failure b/c lungs backing up.

NOOO LV problems b/v valve is so tight the backed up LA still can't overload the LV

med treatment for aortic stenosis?



surgical?

diuretics, beta blockers (decs HR so diastole filling time longer), anti coagulants due to Afib which results in more sitting blood

ball one valvuplasty to open up valve, Valve replacement...artificial means incd clot risk must be on clots, real valve must replace but no coumadin


commisurectomy

mitral regurg. problem could be primary or secondary..describe them

most common cause?

primary --> problem with valve: could be leaflets, chordate tenidane

Secondary--> due to inc LV size...pulls MV apart...IE PAPILLARYS DIE, SCARRED LV PULLS ON CORDS ANNULUS DILATES DUE TO LV SIZE INC

MC-- inc leaflet flare (scarred/can't fuse)

what is a prolapsed leaflet? cause? flil leaflet and cause?

prolapse- bends b/w to atrium and is caused by stretched cords (cords were ripped and replaced by soft tissue) --> MC

flailed leaflet--> flays back to atrium and is due to RUPTURED chords

DO YOU NEED TO TREAT MV PROLAPSE?

NO XRAYS AND STUFF USUALLY COME BACK NORMAL, DONT DO ANYTHING ABOUT IT UNLESS U GET SYMPTOMS

PRIMARY MV REGURG PROLAPSE CAUSES?

SECONDARY MV REGURG CAUSES?

MC TYPE. DUE TO STRETCHED CHORDATE TENDINAE OR LOOSE LEAFLETS

2NDARY- LV STRETCHED OR TOO THICK FROM BEING SCARRED, ISCHEMIA WRECKS PAPILLARY MUSCLED HOLDING CHORDATE TENDINAE

WHAT HAPPENS TO LV IN MITRAL REGURG?

MUST ACCOMODATE HIGHER DIASTOLIC FILLING SINCE LA WILL GET STRETCHED AND FILL MORE

--> LV PRESSURE AND SIXE INCREASES TO ACCOMODATE MORE FLOW

U HEAR S3 OR S4 IN MITRAL REGURG?

WILL BP BE INCD OR DECD?

S3- YES-- FROM LTRYING TO FILL LV with increased volumes

S4- YES FROM ATRIA TRYING TO KICK REGURD BLOOD OUT

IF ACUTE BP WILL BE DECD SINCE ALL BLOOD WILL BACK UP INTO LUNGS AND NOT BE PUMOED OUT BY LV.

CHRONIC WHAT HAPPENS TO LA AND LEFT VENT IN MR???

what happens in acute?

BOTH DILATE, DONT GET STIFFER, LA and LV accommodates via volume!!

no time for LA and LV to to dilate--> get big backup and huge drop in BP since all the blood went backwards--> IN CARDIOGNEIC SHOCK, ALL BLOOD HAS POOLED AND LOW CO

what is virtually diagnostic of mv prolapse?

mid systolic click then murmur

S1.......I~~~~~~~S2

Mitral REGURGITATION (FULL ON) gives what murmur>

holo pan systolic --> since MV should be closed but leak all of systole

should you do surgery? when?

antibiotics for dental work?

treatment?

yes EARLY before LV gets too bad...it slowly dies be/c cytokines that help increase volume also eventually kill it

no don't need them

dec BP with diuretics, beta blockers to stop arrhythmia