Hemodynamic instability 4 aortic stenosis aortic

Info iconThis preview shows page 1. Sign up to view the full content.

View Full Document Right Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: ty 4 Aortic stenosis Aortic stenosis Causes Congenital ,bicuspid, Degenerative, calcified calcified Rheumatic Normal valve area -3-4 cm2, severe -1 cm2, critical <0.8 3-4 cm severe cm <0.8 Symptoms 3 CARDINAL SYMPTOMS Syncope yncope Angina Dyspnoea SAD as Aortic stenosis Aortic stenosis Signs Ejection systolic murmur radiating to neck neck Sustained apex Low volume and slow rising carotid pulse volume slow Treatment Medical Surgical • Once symptomatic 5 Tricuspid Valve Disease Tricuspid Valve Disease Regurgitation LV dilatation-RV dilatation, Ebstein’s Anomaly Ebstein’s RHD. I.E., Prolapse I.E., Prolapse Carcinoid Syndrome Syndrome Stenosis Only trunk RHD, carcinoid, congenital carcinoid congenital Fibroelastosis Tricuspid Valve Disease Tricuspid Valve Disease Murmurs similar to MR/MS except for MR/MS except location location Associated JVP* elevate Associated JVP* Pulsatile liver in TR TR Treatment Medical- diuretics Medical- diuretics Surgery 6 Pulmonary Valve Disease Pulmonary Valve Disease Stenosis Congenital RHD, carcinoid Regurgitation Pulmonary HTN RHD,I.E. Symptoms and signs similar to AS/AR signs AS/AR Treated with surgery when severe Treated surgery Evaluating cardiac murmurs Evaluating Right sided murmurs are accentuated Right during inspiration during Left sided murmurs are accentuated Left during expiration during Murmurs are in general loudest in their Murmurs specified areas (exception to be noted) specified Manoeuvres should be carried out to elicit Manoeuvres murmurs. Valvular Regions Valvular Mitral valve (rt side) (rt Mitral -> apex Aortic valve -> upper right sternal edge Aortic (URSE) (URSE) Tricuspid valve (left side)–> lower left sternal (left Tricuspid –> edge (LLSE) edge Pulmonary valve –> Upper left sternal Pulmonary edge edge Mitral valve disease Mitral Mitral regurgitation Heard loudest at the Heard apex apex High pitched sound Pansystolic murmur Pansystolic Heard loudest in Heard expiration expiration Radiates to the axilla Mitral stenosis Heard loudest at the Heard apex apex Low pitched sound Mid-diastolic murmur Heard loudest in Heard expiration expiration Best heard with Best patient turned on to left side left Aortic valve disease Aortic Aortic regurgitation Heard best at LSE or Heard URSE URSE Early diastolic Early murmur murmur High pitched sound Best heard with the Best patient sitting up and leaning forward with breath held in expiration expiration Aortic stenosis Heard best at the Heard URSE URSE Ejection systolic Ejection murmur murmur High pitched sound Radiates up the neck Radiates along the carotid artery artery Tricuspid valve disease Tricuspid Tricuspid regurgitation Heard best at the Heard LLSE LLSE Heard best during Heard inspiration inspiration Pansystolic murmur May have a pulsatile May liver liver Tricuspid stenosis Heard best at the Heard LLSE LLSE Heard best in Heard inspiration inspiration Mid-diastolic rumble Pulmonary valve disease Pulmonary Pulmonary regurgitation Heard best at the Heard ULSE ULSE In inspiration Early diastolic Early murmur murmur Pulmonary stenosis Heard at theULSE Best in inspiration Ejection systolic Ejection murmur murmur Does not radiate to Does the neck the 7 Congenital Heart Disease Congenital Heart Disease Acyanotic Heart Disease Acyanotic Heart Ventricular Septal Defect Atrial Septal Defect Cyanotic Heart Disease Cyanotic Heart Tetralogy of Fallot etralogy Transposition of the Great Vessels Great Bibliography Bibliography Harrison’s Textbook of Medicine Toronto Notes 2005 Braunwald’s textbook of cardiac diseases...
View Full Document

Ask a homework question - tutors are online