Icm Cardio: Agmon Valvular

Front 1

3 kinds of aortic stenosis

Back 1

valvular
sub-valvular
supravalvular

Front 2

the most common kind of AS is

Back 2

valvular

Front 3

the most common kind of valvular AS is

Back 3

degenerative

Front 4

3 kinds of valvular AS

Back 4

degenerative
congenital
rheumatic

Front 5

congenital valvular AS is due to

Back 5

bicuspid AV

Front 6

the cusps of the AV are ___ (3). they are named after ___

Back 6

left
right
noncoronary
coronary artery emerging near them

Front 7

in 3D echo, diagnosis of AS can be made during ___

Back 7

systole

Front 8

AS due to bicuspid AV usually appears at age ___. AS due to degeneration usually appears at age ___.

Back 8

20
50-60

Front 9

Bernoulli eq

Back 9

delta P = 4v^2

Front 10

normal velocity through AV
common velocity through stenotic AV

Back 10

1 m/s
5 m/s

Front 11

normal AV area
AVA in mild AS
AVA in moderate AS
AVA in severe AS

Back 11

3-4 cm^2
1.5-2 cm^2
1-1.5 cm^2
<1 cm^2

Front 12

peak delta P in severe AS

Back 12

60-70 mm Hg

Front 13

law of laplace

Back 13

tension proportional to (PR)/(wall thickness)

Front 14

in AS, the increase in ___ is offset by an increase in ___

Back 14

P
wall thickness

Front 15

LVH in AS is ___. this means ___

Back 15

concentric
ventricular lumen volume is preserved

Front 16

until the late stages of AS, ___ is preserved

Back 16

LVEF

Front 17

T/F: severe AS can be asymptomatic

Back 17

true

Front 18

AS patients have limited capacity for ___ due to inability to ___.

Back 18

exercise
increase SV

Front 19

in AS the ___ pulse is called ___.

Back 19

carotid
parvus et tardus

Front 20

in AS you can feel ___

Back 20

palpable S4

Front 21

2 AS auscultation findings are ___. if calcification is present, ___ is diminished. if BAV is present, ___ is also heard.

Back 21

systolic murmur
S4
diminished A2
aortic ejection click

Front 22

T/F: AS and hypertension can not coincide.

Back 22

false

Front 23

___ is a good diagnostic technique for AS

Back 23

TTE

Front 24

sudden death is associated with ___ but not with ___. in the former, ___ is the worst predictor, ___ (2) are intermediate, and ___ is most benign.

Back 24

symptomatic AS
asymptomatic AS
CHF
syncope
dyspnea
angina pectoris

Front 25

T/F: statins help AS

Back 25

false: no medical Rx

Front 26

in contrast to AS, AR is caused more commonly by ___ than ___

Back 26

BAV
degeneration

Front 27

2 kinds of AR

Back 27

chronic
acute

Front 28

chronic AR is caused by (6)

Back 28

BAV
degeneration/calcification
RHD
old IE
subaortic membrane
aortic root dilation

Front 29

acute AR is caused by (3)

Back 29

IE
aortic dissection
trauma

Front 30

subaortic membrane can cause AR by ___ which ___s

Back 30

causing turbulent flow
damages valve

Front 31

findings typical for chronic AR are ___ in acute

Back 31

commonly missing

Front 32

symptoms of AR are often worse at ___ because ___

Back 32

night
more time is spent in diastole

Front 33

auscultation findings in AR (2)

Back 33

S3
diastolic murmur

Front 34

in mild AR the murmur is ___, but in severe AR it can be ___. it is best heard at ___ with the patient ___ing.

Back 34

decrescendo
holodiastolic
base of heart, LSB
leaning forward

Front 35

in the Ross operation, the aortic valve is replaced with ___, and the pulmonic valve is replaced with ___.

Back 35

pulmonic valve
homograft

Front 36

bioprostheses have larger orifice area if ___

Back 36

they're not stented

Front 37

the main advantage of bioprostheses over mechanical valves is

Back 37

patients don't need anticoagulation

Front 38

bioprostheses ___ in patients over 65

Back 38

degenerate more slowly

Front 39

the main advantage of homografts is

Back 39

low chance of IE

Front 40

main cause of MS is

Back 40

RHD

Front 41

MS is more/less common in women

Back 41

more

Front 42

normal MV area is ___.
MVA in mild MS is ___.
MVA in moderate MS is ___.
MVA in severe MS is ___.

Back 42

4-6 cm^2
1.5-2 cm^2
1-1.5 cm^2
<1 cm^2

Front 43

in MS, CO at rest is usually ___ and during exertion ___

Back 43

normal
may not increase enough

Front 44

___ is a common arrhythmia associated with MS

Back 44

AF

Front 45

auscultation findings in MS

Back 45

elevated S1

Front 46

elevated S1 in MS is called

Back 46

opening snap

Front 47

MS murmur is high/low pitched

Back 47

low

Front 48

MS with mild symptoms is treated with ___ (2)

Back 48

diuretics
beta blockers

Front 49

because ___, you can't do balloon comissurotomy if there is more than mild ___ present

Back 49

it exacerbates MR
MR

Front 50

2 kinds of MR are ___. ___ is much more common

Back 50

chronic
acute
chronic

Front 51

2 kinds of chronic MR

Back 51

organic
functional

Front 52

causes of organic chronic MR (6)

Back 52

myxomatous MV disease
RHD
mitral annular calcification
congenital defects
HOCM
systemic disease

Front 53

myxomatous MV disease causes MR because it causes ___ aka ___.

Back 53

chordal rupture
flail

Front 54

in MR due to ischemia, unlike MMVD, ___.

Back 54

leaflets are pulled down towards ventricle

Front 55

HF from MR is better/worse than from MS

Back 55

better

Front 56

embolism risk from MR is higher/lower than from MS

Back 56

lower

Front 57

MR without hypercontractility appears in ___

Back 57

end-stage HF

Front 58

the time/shape of MR murmur is ___

Back 58

holosystolic

Front 59

MR murmur is heard at ___ and radiates to ___ or ___

Back 59

apex
axilla
LSB

Front 60

T/F: surgical outcomes for MVP with flail are worse than for ischemic MR

Back 60

false

Front 61

duke major criteria for IE (3)

Back 61

typical IE bacteria present
echo shows endocardial involvement
new valve regurge present

Front 62

duke minor criteria for IE (6)

Back 62

preexisting heart condition
IV drug abuse
fever
vascular phenomena
immune phenomena
blood or echo findings not fitting major criteria

Front 63

if there is moderate/high pre-test probability, you do ___ to check for IE, otherwise ___

Back 63

TEE
TTE

Front 64

the 2 most serious complications of IE are ___. they need ___ for treatment.

Back 64

CHF
peri-valvular infection
immediate surgery