Diseases
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Clinical Findings
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Diagnosis
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Gold standard
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History
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Physical examination
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ECG
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Imaging
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Etiology
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Signs & Symptoms
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Murmur Type
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CXR
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Echocardiogram
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Aortic Stenosis
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- Age-related calcification in the elderly
- Bicuspid aortic valve in the young
- leads to early calcification of the valve
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- Chest pain
- Dyspnea on exertion
- Palpitations
- Symptoms of heart failure
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Systolic murmur
- crescendo-decrescendo murmur
- radiates to the carotids
- heard best at the base
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Left ventricular hypertrophy:
- Wide QRS complex (especially in leads V1-V6)
- ST depression in leads V5-V6
- Left axis deviation
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- Enlarged left ventricle
- Enlarged left atrium and pulmonary artery in severe cases
- Calcification of the aortic valve
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- Thickening and calcification of the aortic valve
- Left ventricular hypertrophy
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Echocardiogram
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Aortic Regurgitation
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- Aortic root dilatation
- Bicuspid aortic valve
- Endocarditis
- Rheumatic fever
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- Diastolic murmur
- early diastolic decrescendo murmur
- Austin Flint murmur
- apical diastolic rumbling
- Maneuvers
- ↑ murmur intensity
- hand grip
- rapid squatting
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Left ventricular hypertrophy:
- Wide QRS complex (especially in leads V1-V6)
- ST depression in leads V5-V6
- Left axis deviation
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- Prominent aortic root/arch
- Enlarged cardiac silhouette
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- aortic regurgitation
- Dilated left ventricle and aorta
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Echocardiogram
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Mitral Stenosis
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|
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Diastolic murmur
- open snap (OS) and delayed rumbling mid-to-late diastolic murmur
- the time between A2 and OS is inversely correlated with severity
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- Right ventricular hypertropy: Dominant R wave in V1 and V2
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- Straightening of the left border of the heart suggestive of enlargement of the left atrium
- Double right heart border (Enlarged left atrium and normal right atrium)
- Prominent left atrial appendage
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- Reduced valve leaflet mobility
- Valve thickening
- Enlargement of left atrium
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Echocardiogram
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Mitral Regurgitation
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- Rheumatic fever
- Endocarditis
- Post-myocardial infarction
- rupture of the chordae or papillary muscles
- Left ventricular dilatation
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- Symptoms of heart failure in severe cases
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- Holosystolic murmur
- high-pitched and radiates towards the axilla
- heard best at the apex
- Maneuvers
- ↑ murmur intensity
- hand grip
- rapid squatting
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Acute MR
Chronic MR
- Enlarged cardiac silhouette
- Straightening of left heart border
- Splaying of subcarinal angle
- Calcification of mitral annulus
- Double right heart border
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- Enlargement of left atrium and ventricle
- Identify valve abnormality
- Valve calcification
- Severity of regurgitation
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Echocardiogram
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