Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

35 Cards in this Set

  • Front
  • Back
ECG findings in valvular HD
ECG findings generally not specific but often provide clues to the presence or type of VHD
Echo in valvular HD
Echocardiography has taken on an extremely important role in the diagnosis and evaluation of severity of VHD
age related VHD (most common)
Etiology of AS
Calcific, related to aging
Consider possibility of sub valvular and supra valvular AS
Clinical manifestations of AS
Angina, CHF, syncope

Cause of LVH and diastolic dysfunction
Physical Examination in AS
Diminished, delayed carotid pulses (pulsus parvus et tardus)
Transmitted bruit
LV heave
Diminished aortic component second heart sound
Early systolic murmur, high pitched, course, musical, 2RICS (Late peaking associated with severity)
Diff b/w AS and Aortic sclerosis
presence or absence of gradient

murmur not transmitted to neck
Treatment of AS
Asymptomatic: possibly can wait to treat
Avoid nitrates
Surgical valve replacement is only reasonable treatment option
Balloon valvuloplasty is at best a temporary fix
Pharm treatment for AS.
No real good pharm for AS
Etiology of aortic regurgitation
Bicuspid aortic valve
Aorta dilation (Marfan’s, CMN, aneurysm, dissection, syphilitic)
Clinical manifestations of AR
Physical findings of AR
Increased carotid pulse (bisferens pulse)
Displaced PMI
Diastolic blow murmur, LSB, possible 2RICS
Austin Flint murmur
Increased pulse pressure
Quinke’s pulse, and similar signs of increased pulse pressure
treatment of AR
Asymptomatic, no sign of LV systolic dysfunction, wait on surgery
Valve replacement
What is Quinke's pulse?
Pink flush in nailbeds from high syst and then white again from low diastolic pressure (overall wide pulse pressure) from AR
Where is AR murmur, systole or diastole?
What gives second impulse in bisferens pulse?
Such a high sys pulse causes a percussion wave
Etiology of Mitral Stenosis
Rheumatic 99.9%
Congenital-parachute mitral valve
Congenital-cor triatriatum
Lutenbacher’s (rheumatic MS with congenital ASD)
Clinical manifestations of MS
CHF, dyspnea, orthopnea, right sided chf, fatigue
Physical Findings of MS
RV heave
Opening snap
Diastolic rumble (don’t confuse with austin flint)
Secondary pulmonary hypertension (increased pulmonic second heart sound)
Secondary TR (systolic murmur, LSB)
AF common
Treatment of MS
Diuretics, treat AF, anticoagulation with AF, AF rate control
Mitral balloon valvuloplasty
Open commisurotomy
Valve replacement surgery
What is opening snap of MS?

What about severity?
Commisural fusion?

more severe = snap is closer to S2 (earlier in diastole)
Diastolic rumble sounds like...
distant sound of thunder
Murmur assoc with blood dripping from anterior leaf of aortic valve
Austin flint
Etiology of Mitral Regurgitation
MV ring dilation (CMO)
Leaflet destruction (rheumatic, endocarditis)
Supporting apparatus disease (ischemia, infarction)
Mitral valve prolapse
Cllinical manifestations of MR
Asymptomatic many years
CHF, dyspnea, orthopnea
Physical findingsof MR
Apical systolic murmur, holosystolic, early, mid late
Systolic click with MVP
Diastolic rumble when regurgitation is severe even without MS
Displaced PMI
Treatment of MR
Mitral valve repair
Mitral valve replacement
Describe murmur of MR

loudest at apex with pt rolled on left side
Tricuspid Regurgitation etiology
Most commonly secondary to pulmonary hypertension from left sided problems, or due to lung disease
Fen-phen, methysergide
Secondary to right side volume overload (ASD, VSD)
Clinical manifestations of TR
Fatigue, dyspnea, edema, ascites, plural effusions right sided CHF
Physical findings of TR
Neck vein distention
Large jugular V waves
Early systolic murmur, LSB, increased with inspiration (Cavallo’s sign)
Treatment of TR
In isolation, often left untreated
Treat left sided problem, pulmonary hypertension
Tricupid annuloplasty ring
Comment on Tricuspid Stenosis?
Right sided CHF
Diastolic rumble, LSB
Comment on Pulmonic Stenosis?
Right sided signs
Early systolic murmur, ULSB
Don’t confuse with ASD, AS
Some cases can be treated with balloon valvuloplasty
Comment on Pulmonic Regurgitation?
Usually secondary to pulmonary hypertension
Diastolic blow, ULSB (Graham Steele murmur)
Easy to confuse with AR
Treat Pulmonary hypertension