Valvular Heart Disease - CRASH! Medical Review Series

[@Baraa.K.Mohammad]

Thank you very much kind sir... I've spent the last week cursing our Cardiology course lecturers for their stupid way in complicating this topic... I almost lost hope that I would understand it... you are a life saver... your work is much appreciated on my heart apex :)

[@dr.musubi1833]

I have learned so much from your videos and really appreciate your jokes & anecdotes. You are great at simplifying difficult concepts. Your charts and summaries are also so useful, I actually think you should just post the charts somewhere so we can use them as study tools! Thank you again!

[@DrSam86]

thanx a Lot man..u have saved my career with those videos

[@moonisahali2451]

No audio... KZbin please fix it

[@promise4775]

i had an hour 30 mins to study this topic the video saved me

[@yahyaelmi8435]

There’s is no voice or is it me ?

[@josannelochanmd]

Hi! Paul, the sound for this video is gone somehow.

[@Ray24393]

Thank you soo much for these videos. They have been so helpful even reviewing for general exams. Thanks for all your effort!

[@edkensalexandre7043]

45:28 His reaction was priceless.😂😂🤣🤣 As if he got tired of these findings for the Mitral Valve Prolapse. Oh man I really wish I could hug you right now.

[@mejoorita]

I love all your videos you're truly a life saver! I seriously owe most of medical knowledge to you

[@KaranveerSingh-gz2yf]

Thank you very much for such a short overview. Really appreciate the hard work you do in making these videos. Again thanks a lot.

[@ghadachakchouk9420]

thank you for these videos. my lectureres have a great way of complicating things in a way that's inimaginable.

[@maramQ]

This video has no sound. Anyone experiencing the same problem?

[@rehminaf9489]

I switch to firefox, there was no sound on safari.

[@jessewilson002]

I have had issues with other videos, but this one has sound for me. I use Chrome.

[@mmaman6931]

Doesn't work on the app but works i chrome

[@xDomglmao]

@@jessewilson002 FF here

[@nnnnn5969]

I really love your videos and I appreciate all the effort you made on them. May God bless you.

[@faryaltahir3597]

Best explanation ever

[@alexhouston86]

First I want to say I am an IM resident and want to tell you I love your videos. Excellent for quick reference for studying and pimp questions! I do have one question. When talking about Aortic Stenosis you mention that it is the only valvular dz that does require ppx abx. My question is in what situation? Is that before replacement? Or is it preoperative for high risk surgeries for endocarditis? I could be wrong, but I thought that any valve replacement with prosthetic material is grounds for ppx abx. Thank you.

[@DrDinooshDeLivera]

Dr. Bolin thank you for your work

[@DrDinooshDeLivera]

Thank you Dr Bolin, really great lecture!

[@saulkassin4236]

No sound!!!

[@anandchaudhary7487]

thank you very much sir. In davidson it is written that Aortic regurgitation murmur is best heard at left sternal border

[@feinussayid2938]

Someone to please share the major differences he mentions on this video compared to the old version of the same topic because there’s no sound on this one

[@lk4472]

No soundd😰

[@50hellkat2]

Very good overview. Thank you.

[@samratspeaks]

Awesome lectures. But got to admit, blowing through toilet paper holder reference was funny! :D :D

[@abidalikhan2786]

The audio isn't working.

[@sherrielevan7400]

Your videos are game changing! Serious, to the poin,t with need to know information! Just one clarification with MS and ABx prophylactic....it IS required for those with a prosthetic value and not for those with a native valve, per Current 2016.

[@umarahisrar2480]

if it helps anyone, the sound wasnt working on my phone on safari but its working on chrome on my laptop.

[@blackdragon482]

Since the impingement of the recurrent laryngeal nerve occurs due to left atrial enlargement, could it be possible to find the same sign with mitral regurgitation as that also is associated with LAE? Thanks!

[@xDomglmao]

Excellent question, thank you for asking. Google says yes: "[...] case reports have described other cardiovascular associations, including left atrial enlargement due to mitral regurgitation or atrial myxoma, severe pulmonary hypertension and congenital heart disease [...]" Source: bjcardio.co.uk/2012/03/ortners-syndrome-an-unusual-cause-of-cough/

[@kelatacute]

Ur videos r life savers ..... Some of them don't have audio tho....pls pls pls fix tht😖

[@intomed]

Be advised AHA Recommended Prophylaxis Guidelines were updated in 2017.

[@xDomglmao]

50:43 I guess squatting does the deal here for the same reason it does in ToF: Increasing the peripheral vascular resistance = incr. BP => incr. flow; in ToF this decreases the right to left shunt (BF so fast, blood just surpasses the shunt and rather enters the lungs), while in MVP the additional blood helps attenuate the clickedy click sound Please correct me if I am wrong :-)

[@AnakinMSMP]

Just a little correction, it's the Ortner sign, not Ortman

[@dr.sumanthmd141]

nice

[@pvhgj]

Good job Anakin

[@edandavidson7234]

Thank you. This is great. Any chance to get the ppt? it will be useful to print and study from

[@davidrose555]

yes it would Edan. So would your contributing to Dr. Pauls Patreon account. But what's the chance of that?

[@oatv]

Sound issue solved on this one, working for me (21/11/18)

[@hastyarxasraw592]

The sound is gone

[@assmmaa1]

Thank you soo much dr for your videos but actullay I'm watching this on august 2018 AND THIS VIDEO HAS NO SOUNDS

[@uzmaaslam7796]

thanks

[@Doctor_Sin_Tabu]

Thank you Doctor!!!

[@alexandersuuley4279]

Thank you so much

[@bomhayhay]

Thanks a lot

[@wartabu4814]

Sound prblm is there

[@bheeshama]

very good

[@manarmohan7008]

Thank u so much u just saved my life ❤️!

[@natashaniaz7075]

thankyou so much

[@blackdragon482]

Can anyone please explain the rationale of the abx prophylaxis in MVP + MR? In the video it is stated that regurgitant flow is the reason necessitating prophylaxis; Why do the indications differ between sole MR and MVP+ MR?

[@wajihkhan8689]

Please correct the sound problem

[@vishaljha8465]

Cant listen the audio, please correct

[@mjl1717]

This guy is Good!!

[@saloniparekh8419]

Is there no sound on this vedio?

[@LA_337]

Hi Paul, You mentioned that there is a displaced apical impulse with Aortic Stenosis. Shouldn't it be with Aortic Regurgitation? With Aortic Stenosis the hypertrophy is concentric and with Aortic Regurgitation the hypertrophy is eccentric. Thereby making LVH in Aortic Regurgitation consistent with a finding of a displaced PMI.

[@oatv]

With aortic stenosis you have to consider the severity of it. If the stenosis is very severe to a point where almost no flux of blood can go through it, then there's an increase of blood volume left in the left ventricule, which will cause an eccentric hypertrophy. This explains why you might find a displaced apical impulse. Up until this stage, the problem is pressure, not volumes, hence concentric hypertrophy, and in this case, the apical impulse can be found in the 5th intercostal space, like it should. Hope I clarified your and whoever has this same doubt. Cheers.

[@xDomglmao]

@@oatv Thanks, mate!

[@agathaagbara654]

There is no sound

[@Adventuresofadoctor]

No sound please

[@muhammadfawad4094]

The most common valvular disease is rheumatic heart disease or mitral valve prolapse?

[@oatv]

The most common valvular disease is aortic stenosis, if i'm not mistaken, and the most common cause for it is aging (calcification of the cuspids)

[@comedy0stuff]

I thought digoxin was a rate control med

[@thinkelite9606]

No sound

[@nicolesandoval1000]

Is there any case where valsalva will increase aortic regurgitation? I am reviewing a question I got wrong on a practice exam and the correct answer was that an AR murmur will INCREASE with valsalva.

[@oatv]

I'm not 100% sure on this, but the Valsalva Maneuver increases the intrathoracic pressure, which at first forces the blood out from the pulmonary circulation and into the left chamber's of the heart, thus increase the stroke volume, which in turn might explain why the regurgitation my increase.

[@xDomglmao]

Probably way too late but I will ask my professor next week if I don't forget it

[@samratspeaks]

Dr Paul, you said Right sternal border is where we can find diastolic murmur in case of Aortic stenosis, I think it should be left sternal border.

[@SaiKrishna-ew2wr]

Samrat Babu Koirala aortic area is on the right side of sterna border.

[@msekenijunior216]

i love it