Carditis/ Valve Stuff

Question 1

• Aortic Valve pathology due to? (3)
• Calcified Stenosis: Effect on LV? Treatment? EDP? Systolic P? Aortic diastolic pressure?
• Bicuspid Stenosis: Aortic root? Common in? Common fusion? Ejection click?
• Regurgitation due to? (2) Ex’s? Ao DP? Pulse pressure? SV? Preload? LV?
• Regurg signs: Corrigans? Quinkes? deMusset? Durozies? Hills?
• Pulmonic Valve: Click with? Which is? Usually due to? Treatment? Rarely?

Answer 1

• Calcified, rheumatic, bicuspid
• LVH; need to replace; high; high; low
• Increased size problem with elastic laminae; males; Left and Right; Yes
• Valve (rheumatic); Aorta (marfans, etc.); Low; High, high, high, big
• rapid up/down of carotid; blanching nailbed; head bob; femoral bruits; greatest SBP in legs more than arms
• Inhalation, rare for RHF; congestion; balloon; replace

Question 2

• Mitral valve: Regurgitation due to? (2)
• Myx regurg is what type of problem? Results in? LV? LA? Exam? Decreases with? Treatment?
• Fx regurg is what type of problem? How? Exam? Treatment?
• Mitral stenosis: Usually due to? Rarely? More common in? LA? Pulmonary hypertension? Treatment? Leads to?
• Tricuspid: Mostly what type of disease? Not?
• Regurg due to? Rare primary diseases? (3)
• Stenosis: Rare but? Murmur increases when?

Answer 2

• functional or myxomatous
• valve; prolapse/ CT problems; overload; enlarged; mild systolic click; valsalva/dehydration; replace
• LV; dilation pulls leaflets away; holosystolic murmur; treat underlying conditions
• R. fever; senile; Women; enlarged; VERY common; valvuplasty; a fib/ HF
• Functional; valve
• 2ndary to pulm htx; Epsteins, RF, Carcinoid (seratonin)
• Carcinoid can do it; inspiration

Question 3

• Myocarditis: Typical cause? Ex? EF? Mortality?
• Dilated CM: What function is impaired? Common causes? (3); Lungs? RAAS? BNP?
• HOCM: Thickening of? Dyastolic function? Systolic function? Common effect? Which is? Treat? (3)
• Restrictive CM: Mostly due to? Prognosis? Common causes? (2) Ventricles? Filling? Systolic function?

Answer 3

• Viral; Cacksacki; Low; 50%
• Systolic; alcohol, genetic, viral; congested; fired up; high
• Septum; Decreased; Increased; Venturi, mitral valve blocks outflow tract; BB, defibrillator, vasodilator
• Infiltrates; bad; amyloides/sarcoids; less compliant; decreased; normal

Question 4

• Pericardium: Role? Connected to?
  1. ) Common cause of A. Peri? Common presentation?
• Exam? (3) Treatment? (3) Not?
  2. ) Pericardial Effusion: Common causes? (2) High intrapericardial pressure can cause? Which is? Similar to?
  3. ) Tamponade: RV filling? When? Paradoxical pulse? Meaning? What does RA do? Leads to? X ray will show? IVC? Venous pressure? EKG? (2) Don’t use? Treat?
  4. ) Constrictive pericarditis: Cause? Diastolic filling? Systolic function? Presentation? X Ray? What is seen on cath? Lungs? Often mistaken for? Treatment?

Answer 4

• Keep heart in place; lung pericardium
  1. ) Viral, CT disease; Pleuritic pain; positional pain
• Pericardial rub, peri fluid, ST elevation; NSAIDS/colchicine; Steroids
  2. ) Viral, metastatic; temponade; impaired diastolic filling; restrictive CM
  3. ) Decreased w/ inspiritation; inspiratory decrease in arterial pressure (no radial pulse with breath); expand into LV; lower SV; enlarged heart with clear lung; dilation without reduction during inspiration; high; low voltage/ alternans with tachy; diuretics; pericardiocentesis
  4. ) Loss of elasticity, radiation, TB; low; normal; Elevated JVP, tachy, hepatomegaly; calcified peri; dip and plateu on diastole pressure (sq root); clear; liver disease; stripping