3.2.2 Cardiac Valve Dysfunction Flashcards

1
Q

What is the key feature of aortic insufficiency?

A

Low diastolic pressure

This is because of back flow of blood from the aorta to LV, blood volume in the arterial system decreases faster than normal during diastole, even though systemic arteriolar resistance is unchanged.

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2
Q

What can be a result of chronic mitral insufficiency?

A

This will lead to elevated atrial pressures which can result in hypertrophy of the LA.

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3
Q

How does mitral insufficiency compare to tricuspid insufficiency?

A
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4
Q

What are some chronic problems associated with mitral stenosis?

A

Pulmonary edema impairs O2 transport and reduces O2 levels in lung tissue.

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5
Q

What will happen to the time of left ventricular systole from aortic stenosis?

A

Aortic pressure rises more slowly than normal and pulse pressure will be reduced. The time for left ventricular systole will be prolonged.

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6
Q

How do aortic insufficiency and pulmonic insufficiency compare?

A
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7
Q

What are the four types of murmurs?

A
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8
Q

What determines the murmur characteristic of mitral stenosis?

A

The pressure gradient is highest across the valve at the beginning of rapid ventricular filling. As blood enters, left atrial pressure falls during diastole. Artial contraction causes the second part of the murmur.

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9
Q

What is this an EKG of?

A

In mitral stenosis the cardiac valve disorder is in the left heart. This will cause right ventricular hypertrophy. Associated with a right axis deviation.

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10
Q
A

D

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11
Q

What are some consequences of backflow from the aorta to the LV?

A

This can result in extra filling of the LV - acute and chronic effects

Abnormal runoff of blood from the arterial system.

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12
Q

What is mitral insufficiency?

A

This is failure of the mitral valve leaflets to close.

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13
Q

What is the notched P wave from in regards to mitral stenosis?

A

Elevated atrial pressure can result in hypertrophy of the LA

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14
Q

What can be a result of chronic aortic stenosis?

A

Increased afterload due to high resistance of the stenotic aortic valve will lead to left ventricular hypertrophy over time.

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15
Q

What is mitral stenosis?

A

The mitral valve doesn’t open completely. This causes a diastolic murmur.

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16
Q

What is the difference between aortic strenosis and pulmonic stenosis?

A
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17
Q

How does mitral stenosis compare to triscuspid stenosis?

A
18
Q

How will valve dysfunctions of the right heart relate to the left heart?

A
19
Q

What is aortic stenosis?

A

The valve leaflets do not open - reducing the size of the opening through which blood is ejected. This increases resistance to LV ejection.

20
Q

What is an important characteristic about stroke volume in aortic insufficieny?

A
21
Q

What are the two systolic murmurs in the left heart?

A

Aortic stenosis and mitral regurgitation

22
Q
A

D

23
Q

What happens to pulse pressure in aortic insufficiency? Why does this occur?

A

Pulse pressure is increased in aortic insufficieny

Left ventricular end diastolic volume is increased, which will increase SV when compared to normal. This will produce a large pulse pressure and higher arterial systolic pressure.

24
Q
A

E

25
Q

How can chronic aortic insufficiency affect the P wave on an EKG?

A

It can become enlarged

26
Q

Can aortic stenosis affect exercise?

A

Patients with aortic stenosis will have severely restricted cardiac output thus most likely having exercise intolerance

27
Q

What is the mnemonic to remember for predicting the sounds associated with each problem?

A
28
Q
A

E

29
Q

What is a diastolic murmur?

A

Begins with or after the second heart sound and ends before the first heart sound

30
Q

What are the important mnemonics to remember?

A
31
Q

What causes the murmur associated with mitral insufficiency?

A

Increased ventricular pressure will be greater than the LA during systole. This will cause a holosystolic murmur

32
Q

What is aortic insufficiency (regurgitation)?

A

This occurs when the aortic valve leaflets fail to close completely. This leads to a backflow of blood from the aorta to the LV

33
Q

What determines the intensity of a murmur?

A

It is directly related to the magnitude of the flow across the defective valve, which is dependent on the pressure gradient driving the flow.

34
Q

What is tricuspid stenosis? How will this affect the mean electrical axis for ventricular depolarization?

A
35
Q

What causes the murmur associated with aortic regurgitation?

A

This is a result of pressure difference decreasing throughout diastole as aortic pressure decreases and LV pressure increases.

Results in a diastolic decrescendo murmur

36
Q
A

E

37
Q

What are the two diastolic murmurs in the left heart?

A

Aortic regurgitation and mitral stenosis

38
Q

What can be a result of chronic aortic insufficiency?

A

Chronic overfilling of the ventricle will result in left ventricular hypertrophy.

39
Q

What is the cause of the specific murmur associated with aortic stenosis?

A

The murmur is dependent on the pressure difference across the valve. Initially the pressure difference is low as ejection begins, and rises as ventricular pressure increases above aortic pressure. As ventricular pressure begins to decrease the pressure difference between the aorta and ventricle becomes. This is the cause of the crescendo-decrescendo

40
Q

What is the hallmark of aortic stenosis?

A

Large pressure difference between the LV and aorta during ventricular systole.

41
Q
A

B

42
Q

What is a systolic murmur?

A

Begins with or after the first heart sound and ends at or before the second heart sound (S1 to S2)