Valvular Heart Disease Overview
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Questions and Answers

During which phase of the cardiac cycle is the mitral valve closed?

  • Both systole and diastole
  • Diastole
  • Systole (correct)
  • Neither systole nor diastole
  • When does aortic insufficiency typically occur?

  • When the aortic valve is open during diastole.
  • When the aortic valve is closed during systole.
  • When the aortic valve is open during systole.
  • When the aortic valve is closed during diastole. (correct)
  • If the aortic valve is open, what phase is the pulmonic valve likely in?

  • Closed during diastole
  • Open during systole (correct)
  • Open during diastole
  • Closed during systole
  • A murmur caused by a ventricular septal defect (VSD) is most likely heard during which phase?

    <p>Ejection phase of systole (B)</p> Signup and view all the answers

    Mitral valve regurgitation due to myocardial ischemia is most likely caused by dysfunction of which structures?

    <p>Papillary muscles and chordae tendineae (C)</p> Signup and view all the answers

    Where is a murmur caused by papillary muscle rupture typically loudest?

    <p>Apex/Mitral area (B)</p> Signup and view all the answers

    When does mitral stenosis typically produce a murmur?

    <p>When the mitral valve is open during diastole. (B)</p> Signup and view all the answers

    Which of the following is considered a surgical emergency?

    <p>Grade V Papillary muscle rupture (C)</p> Signup and view all the answers

    During which phase of the cardiac cycle are the coronary arteries primarily perfused?

    <p>During diastole when the ventricles are relaxed (B)</p> Signup and view all the answers

    What causes the normal heart sounds, S1 and S2?

    <p>The closure of the heart valves (B)</p> Signup and view all the answers

    What condition is associated with the murmur heard during diastole when the atrioventricular valves are open?

    <p>Mitral stenosis (C)</p> Signup and view all the answers

    Which of the following best describes murmurs of insufficiency?

    <p>They occur when a valve is closed. (C)</p> Signup and view all the answers

    If a patient has a systolic murmur due to mitral insufficiency, when would the murmur be present?

    <p>When the mitral valve is closed during ejection. (A)</p> Signup and view all the answers

    A patient with a bicuspid aortic valve is at higher risk for developing which valvular disease?

    <p>Aortic stenosis (A)</p> Signup and view all the answers

    If a patient has a systolic murmur heard at the left sternal border, 5th intercostal space, what might be the potential underlying condition?

    <p>Ventricular Septal Defect (VSD) (B)</p> Signup and view all the answers

    Why does cardiac output and blood pressure decrease with rapid heart rates?

    <p>Decreased filling time during diastole (D)</p> Signup and view all the answers

    Which condition is associated with atrial enlargement due to long term issues, that can lead to atrial fibrillation?

    <p>Mitral stenosis (C)</p> Signup and view all the answers

    During which part of the cardiac cycle are the semilunar valves open?

    <p>During systole (B)</p> Signup and view all the answers

    A patient's heart murmur is heard during systole. Which of the following conditions could be the cause?

    <p>Aortic stenosis (A)</p> Signup and view all the answers

    Which of the following is a cause of valvular disease that is genetic?

    <p>Bicuspid aortic valve (C)</p> Signup and view all the answers

    A murmur of insufficiency is heard when which of these is true?

    <p>The valve is closed (B)</p> Signup and view all the answers

    If a patient has a murmur indicative of tricuspid insufficiency, during which phase of the cardiac cycle would this murmur be heard?

    <p>Systole (B)</p> Signup and view all the answers

    Which of these statements best explains why coronary perfusion is highest during diastole?

    <p>The myocardial tissue is more relaxed, allowing the coronary arteries to fill more easily (B)</p> Signup and view all the answers

    Which cardiac valve pathology is always chronic in nature?

    <p>Mitral Stenosis (C)</p> Signup and view all the answers

    A patient has a diastolic murmur, which of the following valvular conditions is the most likely cause?

    <p>Aortic Insufficiency (C)</p> Signup and view all the answers

    What causes heart valves to open and close?

    <p>Pressure changes above and below the valve (C)</p> Signup and view all the answers

    A patient presenting with a ventricular septal defect (VSD) due to an acute MI would most likely have which type of murmur?

    <p>Systolic murmur heard at the left sternal border (B)</p> Signup and view all the answers

    In a patient with mitral stenosis, why might atrial fibrillation develop over time?

    <p>The atria enlarge in response to increased pressure, causing electrical abnormalities (D)</p> Signup and view all the answers

    What occurs when the mitral valve is open?

    <p>Mitral Stenosis (D)</p> Signup and view all the answers

    What phase occurs when the aortic valve is open?

    <p>Systole (C)</p> Signup and view all the answers

    Which valve is typically closed during Diastole?

    <p>Aortic valve (A)</p> Signup and view all the answers

    What is a key sign of acute mitral valve regurgitation?

    <p>Murmur loudest at the apex (A)</p> Signup and view all the answers

    During which phase is a ventricular septal defect (VSD) murmur typically heard?

    <p>Systole (D)</p> Signup and view all the answers

    Which condition indicates a surgical emergency due to mitral valve function?

    <p>Papillary muscle rupture (Grade V or VI) (B)</p> Signup and view all the answers

    Where is the murmur associated with aortic insufficiency typically best heard?

    <p>Right sternal border (A)</p> Signup and view all the answers

    What structure attaches the mitral valve to the left ventricle wall?

    <p>Chordae tendineae and papillary muscles (A)</p> Signup and view all the answers

    If the tricuspid valve is open, which phase of the cardiac cycle is most likely occurring?

    <p>Diastole (C)</p> Signup and view all the answers

    Aortic stenosis is characterized by a murmur that is auscultated when the aortic valve is:

    <p>Open during systole (C)</p> Signup and view all the answers

    Which of the following valve conditions occurs when the respective valve is closed?

    <p>Aortic insufficiency (A)</p> Signup and view all the answers

    During which phase is the pulmonic valve typically closed?

    <p>Diastole (D)</p> Signup and view all the answers

    A patient is experiencing acute mitral valve regurgitation following a myocardial infarction. Dysfunction of which structures are most likely the cause?

    <p>Papillary muscles and chordae tendineae (B)</p> Signup and view all the answers

    A murmur associated with a ventricular septal defect (VSD) is typically heard during which cardiac phase?

    <p>Systole (A)</p> Signup and view all the answers

    Which of the following would be considered a high-grade and surgical emergency?

    <p>Papillary muscle rupture (Grade V or VI) (A)</p> Signup and view all the answers

    Mitral valve stenosis is characterized by a murmur that occurs when the mitral valve is:

    <p>Open during diastole (D)</p> Signup and view all the answers

    During which phase of the cardiac cycle does the pressure in the ventricle exceed the pressure in the aorta, causing the aortic valve to open?

    <p>Early systole (A)</p> Signup and view all the answers

    A patient is found to have a murmur that increases in intensity as the cardiac cycle progresses towards the second heart sound (S2). What type of murmur is most likely present?

    <p>Aortic Stenosis (A)</p> Signup and view all the answers

    A patient with a history of rheumatic fever is most likely to develop which valvular heart condition?

    <p>Mitral stenosis (D)</p> Signup and view all the answers

    Which of the following best describes the mechanism that prevents backflow of blood through the aortic valve during diastole?

    <p>Higher pressure in the aorta than in the left ventricle (D)</p> Signup and view all the answers

    Which statement correctly describes the timing of murmurs associated with valvular insufficiency?

    <p>Murmurs are loudest during the closing of the affected valve (D)</p> Signup and view all the answers

    A patient with a rapid heart rate develops symptoms of decreased cardiac output and low blood pressure. Which underlying physiological process is the MOST likely cause?

    <p>Decreased ventricular filling time (B)</p> Signup and view all the answers

    A patient’s echocardiogram shows an enlarged left atrium with a long standing history of a mitral valve disorder. Which of the following is the MOST likely underlying cause?

    <p>Mitral stenosis (C)</p> Signup and view all the answers

    Which of the following is MOST accurate regarding the effect of cardiac cycle length, on coronary artery perfusion?

    <p>Reduced diastole decreases coronary perfusion (D)</p> Signup and view all the answers

    A patient is found to have a 'lub-dub-shhh' murmur. Which of the following valvular conditions is MOST likely?

    <p>Aortic insufficiency (A)</p> Signup and view all the answers

    A ventricular septal defect (VSD) may result in a systolic murmur. Where is it most likely to be heard in this case?

    <p>Left sternal border, 5th intercostal space (B)</p> Signup and view all the answers

    Study Notes

    Valvular Heart Disease

    • Four heart valves can be affected by stenosis (narrowing) or insufficiency (regurgitation)
    • Normal heart sounds (S1 and S2) are from valve closures
    • Valves open/close based on pressure differences above and below them
    • Systolic: high pressure, ejection
    • Diastolic: low pressure, filling (longer than systole)
    • Coronaries are perfused during diastole
    • Reduced filling time lowers cardiac output, especially in tachyarrhythmias
    • Pressure above valve higher than below-->valve opens
    • Pressure above valve lower than below-->valve closes

    Causes of Valvular Disease

    • Coronary artery disease, ischemia, acute myocardial infarction
    • Dilated cardiomyopathy
    • Degeneration
    • Bicuspid aortic valve (genetic)
    • Rheumatic fever
    • Infections
    • Connective tissue disease

    Murmurs

    • Murmurs of insufficiency (regurgitation) occur when the valve is closed
    • Can be acute or chronic
    • Murmurs of stenosis occur when the valve is open
    • Stenosis is always chronic, develops over time
    • Stenosis is never acute

    Systolic Murmurs

    • Semilunar valves open during systole
    • Aortic/pulmonic stenosis
    • AV valves closed during systole
    • Mitral insufficiency (large V waves on pulmonary artery occlusion tracing)
    • Tricuspid insufficiency

    Diastolic Murmurs

    • Semilunar valves closed during diastole
    • Aortic insufficiency
    • Pulmonary insufficiency
    • Mitral stenosis (associated with atrial fibrillation)
    • Tricuspid stenosis

    Murmur Summary

    • Mitral insufficiency: murmur occurs when the mitral valve is closed (systole)
    • Mitral stenosis: murmur occurs when the mitral valve is open (diastole)
    • Aortic insufficiency: murmur occurs when the aortic valve is closed (diastole)
    • Aortic stenosis: murmur occurs when the aortic valve is open (systole)

    Murmurs and VSD

    • Ventricular septal defect (VSD) is common in acute myocardial infarction (MI)
    • Can lead to systolic murmur
    • Murmurs during ejection/systole
    • Associated with acute MI

    Valve Function and Papillary Muscle Dysfunction

    • Mitral valve attached to left ventricle via papillary muscles and chordae tendineae
    • Myocardial ischemia/infarction can affect mitral valve function
    • Papillary muscle dysfunction (grades I-II) loudest at apex/mitral area
    • Papillary muscle rupture (grades V-VI) loudest at apex/mitral area is a surgical emergency
    • Ventricular septal defect
    • Murmur location important in diagnosis

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    Related Documents

    Valvular Heart Disease PDF

    Description

    This quiz covers the essential aspects of valvular heart disease, including the effects of stenosis and insufficiency on the heart valves. It also delves into the causes and characteristics of heart murmurs associated with valvular dysfunction. Test your knowledge on cardiac sounds, pressure dynamics, and clinical implications of valvular disease.

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