Cv P1 Valvular Heart Disease

Front 1

what heart sound is atrial contraction

Back 1

S4

Front 2

mitral closure is __ wave

Back 2

C

Front 3

__ wave is peak LA pressure near end systole

Back 3

V

Front 4

suction by rapid filling is __

Back 4

y

Front 5

conditions that increase LA V wave pressure cause what heart sound

Back 5

S3

Front 6

A wave is

Back 6

mitral valve flow

Front 7

what might cause an S4

Back 7

stiff wall

Front 8

a large pressure drop cause (high or low?) velocity jets

Back 8

high

Front 9

is fast high or low frequency

Back 9

high

Front 10

what does aortic regurg sound like

Back 10

holosystolic high pitch because big pressure drop

Front 11

what does diastolic regurg murmur sound like

Back 11

low decrescendo caused by incompetent aortic/pulmonic valve

Front 12

what does mitral stenosis murmur sound like

Back 12

low rumble with two components

Front 13

what two valve problems cause diastolic murmurs

Back 13

mitral stenosis
Aortic insufficiency

Front 14

______ is the most common valve disease in the western world

Back 14

AS

Front 15

what is the most important initiating factor of AS

Back 15

mechanical shear stress

Front 16

hwat is normal aortic valve size

Back 16

3.5-4cm2

Front 17

what is severe AS size

Back 17

<.7

Front 18

T or F. about 20% of severe AS patients develop platelet malfunction and decline in vWF which leads to bleeding

Back 18

true
this can resolve with valve replacement

Front 19

why can't AS increase CO during exercise

Back 19

becuase are pushing against fied outflow tract obstruction... inability to perfuse with reflex vasodilation of exercise leads to syncope

Front 20

what is bezold jarish

Back 20

exertional syncope
mechanoreceptors are stimuated by high pressure and reduce contractility in the face of vasodilation and cause syncope

Front 21

how much area is usually lost per year with AS patients

Back 21

.1-.2cm2

Front 22

what happens to afterload and preload in aortic insufficiency

Back 22

increase
increase

Front 23

what way does FS move in AS

Back 23

left and up
increased pressure

Front 24

the shorter _____ the less time there is for insufficiency

Back 24

diastole

Front 25

what valve problem might imrpove with exercise

Back 25

AI

Front 26

what does aortic insufficiency sound like

Back 26

systolic cres decres
diastolic decrescendo

Front 27

why does diastolic decrescendo stop before the end of diastole in the acute setting

Back 27

becuase such an increase in LV pressure has already slammed the mitral valve shut

Front 28

what valve problem causes hyperdynamic pulses

Back 28

compensated AI

Front 29

in what valve problem do you operate before symptoms

Back 29

AI

Front 30

do you operate on AS before or after sx start

Back 30

after sx

Front 31

what is the advantage of porcine valve

Back 31

no long term anticoagulation

Front 32

what is a con of porcine valve

Back 32

poor hemodynamics
progressive calcification

Front 33

what is the procedure of choice for aortic valve endocarditis complicated by abcess

Back 33

homografts-- cryopreserved explanted human aortic root implants into recipient as entire new aortic valve and root

Front 34

what is the advantage of a mechanical valve

Back 34

good hemodynamics
bad-- thrombosis

Front 35

T or F bio valves are much more likely to degenerate than mechanical

Back 35

true

Front 36

what is the first thing to compensate increased fluids in increased LAP

Back 36

lymph

Front 37

T or F. the mitral valve can be reduced by 50% before any significant pressure gradient develops

Back 37

true

Front 38

why does exercise capacity decrease quickly in mitral stenosis

Back 38

decreased diastolic filling
decreased CO
increased LAP
increased lung edema

Front 39

a consequence of MS ______ is caused by elevation of pressures in the pulmonary venous and capillary system which develops hemorrhages in the pulm vasculature and can cause chronic bronchitis and pink froth

Back 39

hemoptysis

Front 40

what is the primary hemodynamic abnormality in mitral stenosis

Back 40

LAP

Front 41

what changes in heart sounds occur due atrial stenosis

Back 41

OS opening snap
increased S1
diastolic rumble

Front 42

what are MDM and PSM

Back 42

mid diastolic murmur
presystolic murmur
due to aortic stenosis

Front 43

do you need surgery for MS

Back 43

yes absolutely

Front 44

T or F. endocarditis can cause Mitral insuff

Back 44

true

Front 45

what happens to preload and after load in mitral insufficiency

Back 45

increased pre
decreased after

Front 46

when does surgery focus on repair and not replace

Back 46

mitral insufficiency

Front 47

what does a huge v wave tell you

Back 47

mitral insufficiency

Front 48

holosystolic murmur with S3 is

Back 48

mitral insufficiency

Front 49

virtually all cases of pulmonic stenosis are ___ in origin

Back 49

congenital

Front 50

almost all tricuspid stenosis is caused by

Back 50

rheumatic valve disease

Front 51

what valve is most prone to trauma

Back 51

tricuspid

Front 52

heart failure caused by endocarditis is a result of acute valve ____

Back 52

insuff

Front 53

what are duke criteria for

Back 53

endocarditis

Front 54

what does the HACEK group tend to cause

Back 54

endocarditis

Front 55

new murmur, blood infection... could be

Back 55

endocarditis

Front 56

what is your low rumble murmur

Back 56

MS

Front 57

is MR high or low

Back 57

high

Front 58

infective endocarditis that causes HF which is attributed to acut_____

Back 58

insufficiencyq

Front 59

in _____ mitral regurg, atrial pressure increases at end systole and is indicated by a large V wave

Back 59

chronic