Notes in 01. Valvular Heart Disease

To Subscribe, use this Key

Status	Last Update	Fields
Published	06/26/2023	Valve anatomy A = aortic area → {{c1::second}} intercostal space at {{c1::right}} upper sternal border P = pulmonary area → located at&…
Published	06/26/2023	general principlesstenosis in the Atrioventricular valves produce a {{c1::diastolic murmur}} ; whereas regurgitation produces a {{c1::systol…
Published	06/26/2023	murmurs a murmur is caused by {{c1::turbulent}} blood flow in the heart blood flow becomes more turbulent w/ {{c1::higher flow}} v…
Published	06/26/2023	Physiologic Manuevers increased venous return → {{c1::supine position}}, squatting, leg {{c1::elevation}}increases intensity of ALL mur…
Published	06/26/2023	effects of physiologic maneuvers on heart murmurs
Published	06/26/2023	Aortic Stenosis most common valve lesion most cases are caused by degeneration of {{c1::normal aortic valves}} 30% of pts over 65 …
Published	06/26/2023	aortic stenosis much of the underlying pathophysiology is unclear known risk factors for degenerative AS include → [4] {{c1::HTN, DMII, HLD}…
Published	06/26/2023	{{c1::calcified}} aortic stenosis and rheumatic aortic stenosis
Published	06/26/2023	aortic stenosis there is a long period of time where pts w/ mild to moderate stenosis are asymptomatic once the degree of stenosis becomes s…
Published	06/26/2023	aortic stenosis symptoms include progressive {{c1::dyspnea}} on exertion, angina, dizziness, presyncope and syncope other non-specific sympt…
Published	06/26/2023	aortic stenosis murmur is classically described as a {{c1::systolic crescendo-decrescendo}} murmur heard best at the {{c1::right sternal}} b…
Published	06/26/2023	aortic stenosis → workup{{c1::TTE}} is indicated in pts w/ s/s of AS or a {{c1::bicuspid}} aortic valve for accurate diagnosis of the cause of AS, hem…
Published	06/26/2023	aortic stenosis → therapy no medical therapy is helpful aortic valve replacement is recommended for pts w/ {{c1::severe (stage D)}} AS,…
Published	06/26/2023	aortic regurgitation less common than aortic stenosis causes → {{c1::dilation}} of the aortic root (HTN, cocaine abuse, syphilitic aortitis)…
Published	06/26/2023	aortic regurgitation in chronic aortic regurgitation, the increase in backflow into the LV causes {{c2::increased LV end diastolic volume}}, even…
Published	06/26/2023	aortic regurgitation in acute aortic regurgitation, the LV has not yet been allowed to {{c1::remodel}} to accommodate the increase in LV {{c1::en…
Published	06/26/2023	aortic regurgitation → physical exam murmur is a {{c1::diastolic}}, high-pitched "blowing" murmur at the left sternal border pts have a…
Published	06/26/2023	aortic regurgitation → other testing CXR may be normal, though there may be evidence suggestive of a cause. also cardiomegaly in cases of {{…
Published	06/26/2023	Aortic regurgitation in the 2014 ACC/AHA guidelines, Aortic regurgitaiton is given stages similar to AS: Stage A → {{c1::at risk}}Stage…
Published	06/26/2023	aortic regurgitation → treatment acute aortic regurgitation is a surgical emergency, and if this is suspected → STAT {{c1::TTE}} is indicate…
Published	06/26/2023	aortic regurgitation treatment may also involve repair or replacement of the {{c1::aortic root}}, in cases of aortic dissection other option…
Published	06/26/2023	mitral stenosis uncommon 2/3 of all pts are {{c1::female}}higher prevalence in developing nations onset occurs in the {{c1::t…
Published	06/26/2023	mitral stenosis causes almost all are caused by {{c1::rheumatic heart disease}}degenerative (calcified) mitral stenosis is possible, bu…
Published	06/26/2023	mitral stenosis w/ progressive degrees of stenosis, pts experience worsening {{c1::dyspnea}}, PND, orthopnea Chronically elevated …
Published	06/26/2023	mitral stenosis → physical exam Loud {{c1::S1}} (foceful closure of mitral valve) An "{{c1::opening snap}}" after S2 as the valve is fo…
Published	06/26/2023	mitral stenosis → treatment as w/ other valve disease, medical therapy is not helpful in slowing dz progression recommended first line treat…
Published	06/26/2023	mitral regurgitation second most common valvular lesion, behind {{c1::aortic stenosis}} affects 2 mil in US → however, w/ advent of color do…
Published	06/26/2023	mitral regurgitation classification / causes → "Primary" MR → i.e. something wrong w/ the {{c1::valve}} or {{c1::valve apparatus i…
Published	06/26/2023	mitral regurgitation mitral valve prolapse deserves special mention as it is a common cause of mitral regurgitation found in 1-3% of populat…
Published	06/26/2023	mitral regurgitation → on exam classic finding is a {{c1::mid-systolic click}} followed by a late systolic murmur heard at the {{c1::ap…
Published	06/26/2023	mitral regurgitation in chronic MRR, persistent backflow into {{c1::left atrium}} causes {{c1::left atrial dilation}}, subsequent LV di…
Published	06/26/2023	mitral regurgitation in acute mitral regurgitation → MC Mitral valve endocarditis or ischemic mitral regurgitation, the left atirum has not yet b…
Published	06/26/2023	mitral regurgitation schematic ; both acute and chronic
Published	06/26/2023	systolic murmur on left side →  worsens with valsalva → {{c1::hypertrophic cardiomyopathy}}
Published	06/26/2023	mitral regurgitation → physical exam murmur is typically described as {{c1::high-pitched}}, {{c2::holosystolic murmur}} best heard at t…
Published	06/26/2023	older than 65, degenerative calcified but if 30 years old, it's coing to be {{c1::bicuspid aortic valve}}
Published	06/26/2023	I'm {{c1::SAD}} you have Aortic stenosis S → Syncope A → angina D → dyspnea → MC presenting cause
Published	06/26/2023	mitral regurgitation like acute aortic regurgitation, acute mitral regurgitation is a surgical emergency as a temporizing measure, {{c1::art…
Published	06/26/2023	mitral regurgitation → treatment includes standard medical therapy in pts w/ HF in chronic primary MR, surgery is recommended for {{c1:…
Published	06/26/2023	tricuspid stenosis most common etiology is {{c1::rheumatic heart disease}}other less common etiologies include carcinoid syndrome, obstructi…
Published	06/26/2023	tricuspid stenosis symptoms → symptoms of {{c1::right-heart dysfunciton}} → lower extremity edema, ascites, progressive SHOB pts may al…
Published	06/26/2023	Tricuspid Stenosis only highlight stace C → {{c1::asymptomatic}} and Stage D → {{c1::symptomatic}}{{c1::loop diuretics}} can be used to…
Published	06/26/2023	tricuspid regurgitation trivial/mild degrees of TR are common findings on {{c1::TTE}}like mitral regurgitation, causes of tricuspid regurgit…
Published	06/26/2023	tricuspid regurgitation apical displacement of the {{c1::tricuspid valve leaflets}}can present w/ {{c1::right}} heart failure → cyanosis, ar…
Published	06/26/2023	tricuspid regurgitation {{c1::diuretics}} can be used to alleviate right sided volume overload surgery is recommended for pts w/ {{c1::…
Published	06/26/2023	pulmonic stenosis essentially a congenital dz associated w/ {{c1::right-heart dysfx}} and assoicated symptoms on exam → pts have a…
Published	06/26/2023	pulmonic regurgitation mild, and even moderate degrees of pulmonic regurgitation are normal findings on TTE mostly congenital → can appear a…
Published	06/26/2023	antibiotic prophylaxis endocarditis prophylaxis for {{c1::dental procedures}}revised valve guidelines target prophylaxis at ppl who are like…
Published	06/26/2023	Prosthetic valves two types of valves are available: mechanical prosethetic valves, and bioprosthetic tissue valves tissue valves degerate q…
Published	06/26/2023	mitral valve prolapse deserves special mention as it is a common cause of {{c1::mitral regurgitation}}
Published	06/26/2023	prosthetic valves {{c1::anticoagulation}} → required for all pts w/ mechanical valves target INR → {{c1::2.5 - 3.5}}mechanical aortic valve …
Published	06/26/2023	anytime you see a 35 year old female w/ murmur → think {{c1::mitral stenosis}} or {{c1::MVP}} ; if there's a {{c1::high-pitched diastol…
Status	Last Update	Fields