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35 Cards in this Set

  • Front
  • Back
3 Etiologies of Aortic stenosis.
Congenital, Rheumatic Valve Disease, Age-related calcification
What is the physiologic compensation mechansim for Aortic Stenosis?
Concentric LV hypertrophy leading to concomitant LA hypertrophy
What are 3 the major symptoms, not structural changes, in advanced Aortic Stenosis and Why do they occur?
Angina (supply can't meet demand); Syncope (can't increase CO with exercise), CHF (with time LVEDV increase, insurmountable AL, leading to congestion)
What are the PE findings (murmurs, carotid pulse change, S2 effect) in Aortic Stenosis?
coarse late peaking systolic ejection murmur; weak Carotid upstroke pulse; S4; loss of aortic portion of S2
What is used to confirm AS? Treatment for Aortic Stenosis?
Confirmed by Cardiac catherization, treatment by AVR onces LV dysfunction is great enough + prophylaxis
What are the 2 mechanisms that cause Aortic Regurgitation?
Aortic leaflet disease; dilatation of the aortic root
How does Acute Aortic Regurgitation present? Treatment?
MEDICAL emergency appears with normal LV but quick volume overload has caused pulmonary edema; AVR STAT!
Describe compensation in Chronic Aortic Regurgitation.
Compensatory adaptation to volume overload has occurred (dilatation and to a lesser degree LV hypertrophy);
What condition gives you a Widened Pulse Pressure?
Hallmark of Aortic Regurgitatoin
What are the most frequent patient complaints when presenting with chronic Aortic Regurgitation?
dyspnea on exertion, fatigue, forceful heartbeat;
Describe Treatment for Asymptomatic & Symptomatic AR.
If Asymptomatic follow closely LV function and prophylaxis for endocarditis; Symptomatic: some efficacy with VDs/CCBs/diuretics to delay AVR prior to decompensation;
TRUE/FALSE - Tricuspid Stenosis is common and often a complication related to Rheumatic Heart Disease.
False - rare but related to RHD
What are the Common PE findings (JVP, murmurs, palpations, etc) in Tricuspid Stenosis.
JVD with large a wave; Opening Snap with diastolic murmur; hepatomegaly/abdominal distention
Treatment for Tricuspid Stenosis.
Valvuloplasty or Replacement
Describe what usually causes Tricuspid Regurgiation.
Functional, in that RV dilatation prevents full closure.
Common PE findings (JVP, murmurs, palpations,etc) in Tricuspid Regurgitation.
Prominent v waves in jugular veins (RA dilation), systolic murmur, pulsatile liver (back pressure from ventricle)
TRUE/FALSE - Often treatment for Tricuspid Regurgitation requires complete replacement.
False - treat the underlying RV enlargement
TRUE/FALSE - Pulmonic Stenosis is rare and usually a congenital lesion treated by ballon valvuloplasty.
What is the most frequent cause of pulmonic regurgitation?
Severe pulmonary HTN
What is main negative for the long lasting mechanical valves when compared to bioprosthetic valves? Often recommended to what group?
thrombogenic surface requiring lifelong anticoagulation; Younger patients
What is the main negative for porcine valves when compared to mechanical valves? Often recommended to what group?
less durable requiring more frequent replacement; the elderly( more negatives with anticoagulation)
TRUE/FALSE - All valve replacements require lifetime abx prophylaxis for endocarditis.
Describe the 2 conditions for Acute Bacterial Endocarditis.
Acute, fulminant endocardial infection with highly virulent and invasive microbe (if less virulent, SBE)
Describe the pathogenesis of Endocarditis.
1. endocardial surface injury (often via turbulent flow);
2. thrombus formation;
3. bacteria entry into circulation (usually G+);
4. bacterial adherence to fibrin laid down by Platelets (then coated and protected);
5. Possible embolism leading to infarcts;
Right Sided Infective Endocarditis is seen often in (blank).
Intravenous Drug users
What is the Treatment strategy for infective endocarditis?
1st obtain blood culture, 2nd IV abx can be directed at the microorganism,3rd if persistent bacteremia then valve replacement
Normal Aortic Valve
Congenital Pulmonary Stenosis
Combined aortic and mitral stenosis seen with LA dilation and LV hypertrophy
TRUE/FALSE - Marantic Endocarditis is non inflammatory, non destructive and non infective but can still cause thrombotic embolization.
Marantic Endocarditis
Disease process?
What heart disease process is associated with SLE & Collagen Vascular Disease?
Libman-Sacks Endocarditis
Libman Sacks Endocarditis
Carcinoid Heart tumors from the GI tract cause valvular fibrosis via production of (blank).
vasoactive metabolites (serotonin)
What disease condition is Distinguished by large atrial gelationous mass?
Cardiac Myxoma