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Medicine Notes Clinical Cardiology Notes

Valvular Heart Disease Notes

Updated Valvular Heart Disease Notes

Clinical Cardiology Notes

Clinical Cardiology

Approximately 39 pages

This series of notes is on clinical cardiology. These notes were made using a variety of textbooks, notes from tutorials with consultants and knowledge gained on the ward with doctors. These notes helped me a achieve a good grade of 68% in the end of year exams....

The following is a more accessible plain text extract of the PDF sample above, taken from our Clinical Cardiology Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

MITRAL VALVE

  • Mitral stenosis

    • Causes

      • Rheumatic (COMMONEST)

      • Congenital

      • Mucopolysaccharidoses (metabolic disorders= absence of enzymes)

      • Endocardial fibroelastoses

      • Prosthetic valve

    • Presentation (symptomatic when orifice <2cm2)

      • Dyspnoea

      • Fatigue

      • Palpitations

      • Chest pain

      • Systemic emboli; Haemoptysis; Chronic bronchitis

    • Signs

      • Malar flush

      • Low-volume pulse

      • AF

      • Tapping, non-displaced apex

      • Auscultation= Loud S1; Rumbling mid diastolic murmur

    • Tests

      • ECG AF; P mitrale; RVH

      • CXR L atrial enlargement; Pulmonary oedema; Mitral valve calc.

      • Echo Diagnostic (as is cardiac catheter)

    • Management

      • Medication= rate control; warfarin; diuretics

      • Balloon valvuloplasty

      • Surgery (presence of gradient by cath >4mmHG)

        • Open mitral valvotomy/commissurotomy

        • Valve replacement

    • Complications

      • Pulmonary hypertension

      • Emboli

  • Mitral regurgitation

    • Causes

      • Functional (LV dilatation)

      • Annular calc.

      • Rheumatic fever

      • IE

      • MV prolapse

      • Ruptured cordae tendinae

      • Papillary muscle dysfunction/rupture

      • CTDs

      • Cardiomyopathy

      • Congenital

      • Appetite suppressants

    • Symptoms & signs

      • CHF symptoms

      • IE

      • Displaced hyperdynamic apex

      • RV heave

      • Auscultation= Pan-systolic murmur

    • Tests

      • ECG AF; P mitrale; LVH

      • CXR Big LA & LV; mitral valve calc; pulmonary oedema

      • Echo & cardiac catheterisation

    • Management

      • Medication= Rate control; warfarin; diuretics

      • Surgery= Deteriorating symptoms (repair/replace)

  • Mitral valve prolapse

    • General

      • Most common valvular abnormality

      • Alone/with ASD; patent ductus arteriosus; cardiomyopathy; CTD

    • Symptoms

      • Asymptomatic

      • Atypical chest pain & palpitations

      • Autonomic dysfunction (anxiety, panic attack, syncope)

    • Signs= Mid-systolic click/systolic murmur

    • Complications

      • Mitral regurg./ Cerebral emboli/Arrhythmias/Sudden death

    • Tests

      • Echo Diagnostic

      • ECG Inferior T inversion

    • Management

      • B-blockers (pain and palpitations)

      • Severe= surgery

Aortic Valve

  • Aortic stenosis

    • Causes

      • Senile calcification (COMMONEST)

      • Congenital

      • Rheumatic heart disease

    • Symptoms and signs

      • Chest pain; Exertion dyspnoea; Syncope

        • Classic triad= Angina + Syncope + HF

      • Slow rising pulse; Heaving non-displaced apex

      • Auscultation= Holo-systolic murmur (radiates to carotids)

    • Tests

      • ECG P-mitrale; LVH

      • CXR Minimal changes initially; Cardiomegaly later

      • Echo Diagnostic. +ve= Cardiac catheterisation (increased pressure)

    • DDx= Hypertrophic cardiomyopathy

    • Management

      • Symptomatic= Poor prognosis without surgery

  • Aortic sclerosis= Senile degeneration--> Ejection systolic; No carotid radiation; Normal pulse

  • Aortic regurgitation

    • Causes

      • Acute= IE; Ascending aorta dissection; Chest trauma

      • Chronic

        • Congenital; CTD; Rheumatic fever; Vasculitides; RA; Arthritides; HTN

    • Symptoms

      • SOB; Palpitations; Angina; Syncope; Orthopnea

    • Signs

      • Collapsing pulse; Wide pulse pressure

      • High pitched early diastolic murmur

      • de Musset's sign; Quinke's sign

    • Tests

      • ECG LVH

      • CXR Cardiomegaly; Dilated ascending aorta; Pulmonary oedema

      • Echo Diagnostic. Cardiac catheterisation (severity)

    • Management

      • ...

Buy the full version of these notes or essay plans and more in our Clinical Cardiology Notes.