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10 Cards in this Set
- Front
- Back
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419. General characteristics of Tricuspid regurg?
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a. TR results from a failure of the tricuspid valve to close completely during systole, causing regurg of blood into R. atrium.
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420. Causes of Tricuspid regurg?
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a. TR is usually secondary to RV dilatation. Any cause of RV dilatation can result in enlargement of the tricuspid orifice.
i. Left ventricular failure is the most common cause. ii. R. ventricular infarction. iii. Inferior wall MI iv. Cor pulmonale, secondary to pulmonary HTN. b. Tricuspid endocarditis- Seen in IV drug users. |
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421. Causes of tricuspid regurg continued?
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a. May be secondary to rheumatic heart disease; usually accompanied by mitral and aortic valve disease.
b. Epstein’s anomaly- congenital malformation of tricuspid valve in which there is downward displacement of the valve into the RV. c. Other causes include carcinoid syndrome, SLE, and myxomatous valve degeneration. |
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422. Clinical features of tricuspid regurg?
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a. Signs and sx of RVF (ascites, hepatomegaly, edema, JVD)
b. Pulsatile liver c. Prominent V waves in jugular venous pulse w/rapid y descent. d. Inspiratory S3 along left lower sternal border (LLSB) may be present. e. Blowing holosystolic murmur!!!! 1. At LLSB f. Right ventricular pulsation along LLSB g. AFib is usually present. 423. What intensifies or reduces tricuspid regurg murmur? a. Intensified w/inspiration b. Reduced during expiration or the Valsalva maneuver |
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423. What intensifies or reduces tricuspid regurg murmur?
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a. Intensified w/inspiration
b. Reduced during expiration or the Valsalva maneuver |
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424. Diagnosis of tricuspid regurg?
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a. Echocardiogram:
1. Quantifies amount of TR 2. Identifies prolapse/flail of tricuspid valve leaflets 3. Measures pulmonary pressures 4. ECG: RV and RA enlargement |
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425. Tx of Tricuspid regurg?
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a. Tx left-sided heart failure, endocarditis, or pulmonary HTN
b. Severe regurg may be surgically corrected if pulmonary HTN is not present. 1. Native valve repair surgery 2. Valvuloplasty of tricuspid ring. 3. Valve replacement surgery: rarely performed. |
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426. Mitral Valve Prolapse?
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a. MVP is defined as the presence of excessive or redundant mitral leaflet tissue due to myxomatous degeneration of mitral valve leaflets and/or chordae tendinea.
b. The redundant leaflet(s) prolapse toward the L. atrium in systole, which results in the auscultated click and murmur. c. MVP is common in pts w/genetic connective tissue disorders, such as Marfan’s syndrome, osteogenesis imperfecta, and Ehlers-Danlos syndrome. d. MR may occur, but it is rare. e. Arrhythmias and sudden death are very rare. |
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427. Symptoms of MVP?
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a. Most pts are asymptomatic for their entire lives.
b. Palpitations and atypical chest pain may occur. c. TIAs due to emboli from mitral valve have been reported, but are very rare. |
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428. Signs of MVP?
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a. Midsystolic or late systolic click(s).
b. Mid-to-late systolic murmur c. Some pts have midsystolic click w/out murmur; others may have the murmur w/o the click |
