| Term | Definition |
|---|
| aortic stenosis | triad: chest pain, syncope, dyspnea |
| aortic stenosis | delayed, weak carotid upstroke |
| aortic stenosis | soft/absent s2 |
| murmur: late systolic crescendo/decrescendo at base, radiates to carotids | aortic stenosis |
| aortic regurg | bouding central pulses |
| aortic regurg | pulsus bisferiens |
| aortic regurg | Quincke's pulses |
| murmur: diastolic decrescendo at 2nd interspace, radiates to apex | aortic regurg |
| aortic regurg | Duroziez's sign |
| aortic regurg | wide pulse pressure |
| valve deficiency: left-sided | heard best during end expiration |
| causes: RF, calcification, congenital bicuspid valve, endocarditis | aortic stenosis |
| prognosis: 5 years from angina, 3 years from syncope, 18 mo from CHF | aortic stenosis |
| pathophys: high resistance = high LV pressure => LV hypertrophy => stiff, decreased pulse volume | aortic stenosis |
| tx: doppler/surgery, balloon valve | aortic stenosis |
| causes: RF, calcification, endocarditis, trauma, Marfan's | aortic regurg |
| pathophys: leak increases LV filling volume => dilation, high stroke volume | aortic regurg |
| prognosis: acute cases poorly tolerated | aortic regurg |
| dx/tx: afterload reduction (preload if pulmonary edema), surgery, exercise limitation | aortic regurg |
| causes: RF, calcification, CT disorders (SLE, RA), congenital | mitral stenosis |
| pathophys: atrial pressure increased => dilation => A-fib, pulmonary HTN; LV is normal | mitral stenosis |
| murmur: diastolic, heard at apex. low pitched | mitral stenosis |
| mitral stenosis | opening snap before S2 |
| prognosis: 5 year progression to severe disability | mitral stenosis |
| mitral stenosis | thickened, fused leaflets |
| tx: diuresis, B-blockers, surgery | mitral stenosis |
| causes: leaflet destruction, myxomatous degen, papillary muscle dysfxn, cardiomyopathy | mitral regurgitation |
| pathophys: leak => atrial pressure increased => atrial dilation => LV dilation => decreased contractility, pulmonary HTN, edema | mitral regurgitation |
| murmur: holosystolic at apex, radiates to axilla | mitral regurgitation |
| mitral regurgitation | normal S2 + S3 |
| tx: preload and afterload reduction, anti-arrythmics, inotropes | mitral regurgitation |
| prognosis: normally well tolerated | mitral regurgitation |
| causes: pulmonary HTN, endocarditis, PE, RV infarct | tricuspid regurg |
| tricuspid regurg | JVD, hepatomegaly, peripheral edema, anorexia/bloating, exertional fatigue |
| tricuspid regurg | sleep disturbance |
| murmur: systolic murmer, epigastric | tricuspid regurg |
| tx: diuresis, preload reduction, valve replacement | tricuspid regurg |
| causes: congenital, endocarditis | pulmonary stenosis |
| pathophys: high resistance => RV hypertrophy/HTN, reduced LV filling | pulmonary stenosis |
| pulmonary stenosis/insufficiency | JVD, peripheral edema, dyspnea, exertional fatigue |
| tx: surgery, judicious preload reduction | pulmonary stenosis |
| causes: endocarditis, congenital, pulmonary HTN | pulmonary insufficiency |
| murmur: systolic, 2nd interspace left | pulmonary stenosis |
| murmur: diastolic, 2nd interspace left | pulmonary insufficiency |
| causes: pulmonary HTN, pulmonic atresia/stenosis | cor pulmonale |
| pathophys: fibrosis/obstruction => increased pulmonary resistance => RV dilation, hypertrophy | cor pulmonale |
| cor pulmonale | hypoxemia, peripheral edema, hepatomegaly |
| tx: gentle diuresis, o2, endothelin inhibitors | cor pulmonale |
| causes: myxomatous degeneration, genetics, CT diseases | MVP |
| murmur: none (severe only); usually a mid-systolic click | MVP |
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