Valvular heart disease pathophysiology and hemodynamic consequences tested on USMLE Step 1, deeper than the auscultation focus of the murmurs and heart sounds deck.
35 cards · basic cards · AI-written, checked twice. Edit anything.
- In patients over 65, what is the most common cause of aortic stenosis?
- Calcific (degenerative) aortic valve disease
- In patients under 65, what is the most common cause of aortic stenosis?
- Bicuspid aortic valve
- What type of left ventricular hypertrophy results from the chronic pressure overload of aortic stenosis?
- Concentric hypertrophy
- What carotid pulse finding is classic for severe aortic stenosis?
- Pulsus parvus et tardus (weak and delayed upstroke)
- The classic symptom triad of severe aortic stenosis is angina, ____, and heart failure.
- syncope
- Why does severe aortic stenosis cause exertional syncope?
- Fixed cardiac output cannot rise to match exercise-induced peripheral vasodilation, causing cerebral hypoperfusion
- Why does severe aortic stenosis cause angina even without coronary artery disease?
- LV hypertrophy raises myocardial oxygen demand while high intraventricular pressure lowers coronary perfusion pressure
- Roughly what is the average survival after a patient with aortic stenosis develops heart failure symptoms, without valve replacement?
- About 2 years
- What type of left ventricular change results from the chronic volume overload of aortic regurgitation?
- Eccentric hypertrophy (ventricular dilation)
- What is the rapidly rising and suddenly collapsing pulse of severe aortic regurgitation called?
- Corrigan pulse (water-hammer pulse)
- What is the head-bobbing sign seen with each heartbeat in severe aortic regurgitation called?
- de Musset sign
- Besides bicuspid aortic valve, what connective tissue disorder causing aortic root dilation can lead to aortic regurgitation?
- Marfan syndrome
- Why is acute aortic regurgitation poorly tolerated compared to chronic aortic regurgitation?
- The LV has no time to dilate and compensate, so LV diastolic pressure rises rapidly, causing pulmonary edema and cardiogenic shock
- What is the most common cause of mitral stenosis worldwide?
- Rheumatic heart disease
- How does mitral stenosis predispose to atrial fibrillation?
- Elevated left atrial pressure causes left atrial enlargement, which promotes atrial fibrillation