Show:
Bicuspid Aortic Valve
Aortic Stenosis
Heart Sounds
Heyde Syndrome
Heart Failure
100

What anatomical defect causes early calcification in a young patient?

Bicuspid aortic valve

100

Aortic stenosis is a type of left ventricular ________.

Outflow obstruction

100

What heart sound can be heard from diastolic heart failure?

S4

100

In a patient with aortic stenosis, chronic bleeding from fragile colonic vessels can lead to this laboratory finding. (Also seen in our patient).

Low hemoglobin

100

What type of heart failure is caused by aortic stenosis?

Diastolic

200

How are the calcium levels in dystrophic calcifications? 

Normal

200

Although this medication class does not fix the valve narrowing in aortic stenosis, it is often used to relieve pulmonary congestion and symptoms of fluid overload in patients with left ventricular diastolic dysfunction.

Diuretics

200

The aortic stenosis murmur is best auscultated in.....

the right 2nd intercostal space

200

Chronic GI bleeding from angiodysplasia in Heyde syndrome most commonly leads to:

Iron deficiency anemia

200

The equation for ejection fraction is?

SV/EDV

300

What test would you order to screen relatives of a patient with a bicuspid aortic valve?

Echocardiography 

300

What pattern determines left atrial enlargement on ECG?

Biphasic P wave, P mitrale




1. Lead II – “P mitrale”

  • Broad, notched P wave (≥ 120 ms)
  • Double hump / M-shaped P wave
  • Reflects delayed left atrial depolarization

2. Lead V1 – Biphasic P wave

  • Initial positive deflection → right atrium
  • Terminal negative deflection → left atrium
  • LAE indicator:
    • Terminal negative portion > 1 mm deep and > 40 ms wide
300

The aortic stenosis murmur radiates to....

the carotids.

300

This definitive treatment reverses the underlying pathophysiology by eliminating the shear stress on vWF.

Aortic valve replacement

300

What are the two most common causes of diastolic heart failure?

Aortic stenosis and hypertension

400

What is the inheritance of bicuspid aortic valve? State the 3 characteristics.

Autosomal Dominant. Incomplete Penetrance. Variable Expressivity.

400

The classic triad of aortic stenosis is:

exertional dyspnea, angina, and syncope


Angina without atherosclerosis due to increased myocardial demand from the high pressures generated.

400

An aortic stenosis murmur is best heard with..... (think breathing).

Expiration

400

Loss of large vWF multimers impairs platelet adhesion, particularly in this type of high-flow vascular lesion. 

Angiodysplasia

400

Diastolic heart failure causes blood to back up into ______ and ______.

The left atrium and the lungs. 

500

What gene is most associated with bicuspid valve stenosis?

Most associated with NOCTH1 gene + TGF-B epigenetic alterations

500

“In aortic stenosis, increased left ventricular pressure from outflow obstruction produces this classic carotid pulse finding characterized by a weak and delayed upstroke.”

pulsus parvus et tardus

500

Heart sound generated by aortic stenosis. (Not heart failure)

Single S2, harsh crescendo-decrescendo systolic ejection murmur

500

High shear stress across a stenotic aortic valve causes proteolysis of this key platelet adhesion protein. 

von Willebrand factor (vWF).

500

How are sarcomers added in concentric heart failure?

In parallel 


Concentric hypertrophy is due to pressure overload.

The heart wall thickens while the chamber size remains relatively normal > stiff ventricle with normal EDV > decreased compliance with maintained stroke volume > Ejection fraction remains normal