Valvular Heart Disease

Dr. nada

Learning Outcomes

By the end of this session, the student should be able to:

Recognize the common etiologies of valvular stenosis and regurgitation.
Recognize the signs and symptoms of severe valvular stenosis and regurgitation.
Outline the management of different valvular lesions.

Aortic Presentation

Systolic Murmurs - aorta open	Diastolic Murmurs/Sounds
(crescendo-decrescendo) AS = aortic stenosis & PS = pulmonary stenosis HCM = hypertrophic cardiomyopathy	(Early Diastolic/Decrescendo) AR = aortic regurgitation PR = pulmonary regurgitation
(Holosystolic/Pansystolic) MR = mitral regurgitation TR = tricuspid regurgitation VSD = ventricular septal defect	(Mid-late Diastolic/ decrescendo- crescendo) MS = mitral stenosis TR = tricuspid stenosis
I = innocent murmur	S3 = third heart sound
	PDA = patent ductus arteriosus (continuous murmur)

SDL

Basic Concept

Regurg/Insuff: Leaking (backflow) of blood across a closed valve.

Stenosis: Obstruction of (forward) flow across an opened valve.

Systole:

AV/PV – opens-------Aortic Stenosis
S1-S2 – MV/TV – closes------Mitral Regurg

Diastole:

AV/PV – closes------Aortic Regurg
S2-S1 – MV/TV – opens-------Mitral Stenosis

These concepts are set in stone; it can’t occur any other way. It would be anatomically impossible.

Normal Heart Sounds & S2 SplittingZ

Wide splitting - Pulmonic Stenosis & Right bundle branch block Fixed Splitting - ASD Paradoxical Splitting - Aortic Stenosis & Left bundle branch block