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25 Cards in this Set
- Front
- Back
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what is the difference between exertional fatigue and exertional dyspnea?
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exertional fatigue: pt stops doing whatever they were doing because they are tired
exertional fatigue: pt stops doing whatever they were doing because they can't breath |
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what is the symptomatic presentation of tricuspid regurgitation?
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exertional fatigue
anorexia/bloating peripheral edema sleep disturbance |
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what are the 4 etiologies of tricuspid regurgitation?
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pulmonary HTN
endocarditis acute PE RV infarction |
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what are the 6 clinical signs of tricuspid regurgitation?
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JVD
RV heave epigastric systolic murmur hepatomegaly peripheral edema LFT abnormalities |
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how do you tx tricuspid regurgitation?
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diuresis
preload reduction and valve replacement |
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what is the symptomatic presentation of pulmonic stenosis?
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exertional fatigue
dyspnea signs of RV HTN |
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what are the 2 etiologies of pulmonic stenosis?
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congenital and endocarditis
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what type of murmur do you hear in pulmonic stenosis? what other valvular disorder does this murmur sound like?
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systolic murmur in the second left interspace. Very similar to aortic stenosis, but in a different location.
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what are the signs associated with pulmonic stenosis?
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systolic murmur
RV heave JVD peripheral edema |
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how do you tx pulmonic stenosis? what other valvular disorder has the same tx?
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surgery
judicious preload reduction... only to keep them stable until surgery same tx as aortic stenosis |
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what is the pathophysiology of pulmonic stenosis?
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increase outflow gradient --> RV hypertrophy--> RV HTN --> RV pressure overload --> reduced LV filling --> peripheral venous congestion.
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what are the 3 etiologies associated with pulmonic regurgitation? which one is the most common?
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endocarditis
congenital pulmonary HTN -MC |
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what other valvular disorder is presented clinically like pulmonary regurgitation?
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Pulmonic stenosis
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what murmur is associated with pulmonary regurgitation? what other valvular disorder presents with the same type of murmur?
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decrescendo diastolic murmur in the 2nd left interspace. this is idential to aortic insufficiency, just in a different location.
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what are the clinical signs associated with pulmonic regurgitation?
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decrescendo diastolic murmur and signs of RV volume/pressure overload.
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how do you tx pulmonary regurgitation?
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preload reduction
tx for pulm HTN |
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what is the definition of cor pulmonale?
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cardiac structural and functional changes induced by chronic pulmonary HTN or pulmonary outflow obstruction
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what are the 3 etiologies for cor pulmonale?
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pulmonic stenosis or atresia
idiopathic pulmonary HTN secondary pulmonary HTN (chronic PE, LV failure COPD, CT dz) |
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what is the pathophysiology of cor pulmonale?
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pulmonary microvascular fibrosis/ obstruction --> increased pulmonary vascular resistance --> increased right ventricular afterload --> RV dilation and hypertrophy --> RV systolic failure
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what are the 3 signs of RV failure>
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peripheral edema
abdominal ascites hepatomegaly and congestive hepatopathy |
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how does cor pulmonale clinical present?
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progressive exertional dyspnea
progressive hypoxemia signs of RV failure |
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what will the echo show for cor pulmonale?
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the RV is in worse shape than the LV. Generally LV is normal.
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what are the different clinical signs between left heart failure and cor pulmonale?
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left HF: displacement of the PMI, pulmonary edema, bigger left side on CXR than right
cor pulmonale: normal PMI, no pulmonary edema, bigger right side on CXR than left |
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how do you tx cor pulmonale?
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address reversible causes
gentle diuresis oxygen therapy pulmonary arteriolar dilators endothelin inhibitors |
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what is the only pulmonary arteriolar dilator on the market?
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VIAGRA!!!!
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