2B Flashcards
(18 cards)
What is the first heart sound?
Closure of mitral and tricuspid valves at the onset of ventricular contraction
What is the second heart sound?
Closure of semilunar valves (pulmonary and aortic) Shorter and of higher frequency than S1 - end of ventricular systole and beginning of ventricular diastole
What causes heart murmur?
When blood flow strikes obstructions and the flow becomes turbulent.
What do heart murmurs indicate?
Valve problems (but not always, fairly common in children with perfectly healthy hearts)
What does a “swishing” sound indicate?
an incompetent valve
What does a high-pitch or “click” indicate?
stenotic valve (narrowing of valve)
What happens if a valve does not open properly?
valvular stenosis
What happens when a valve does not close properly?
valvular regurgitation/incompetence/insufficiency
What is the end result of valvular regurgitation/incompetence/insufficiency?
Myocardial hypertrophy - a compensatory mechanism intended to increase the pumping capability of the heart
What does rheumatic fever have to do with heart valve disease?
Valvular heart disease occurs often as a late result of rheumatic fever (caused by strept throat infection)
What are some other causes of heart valve disease?
Can be congenital. Can occur with prosthetic valves that are subject to physical deterioration
What can rheumatic fever lead to?
endocarditis, which in turn can lead to valvular damage
What is it about rheumatic fever that causes heart valve disease?
RF can cause warty growths along the lines of closure of the valve leaflets. This will heal but can cause thickening, fibrosis, deformation, often with fusion of valve cusps and thickening of chordae tendineae. Calcification
Which of the heart valves is most frequently involved in Rheumatic heart disease?
Mitral valve (left)
What are the clinical manifestations of mitral stenosis?
increase in LA pressure and hypertrophy. Hypetrophy of LV, Increased risk of atrial dysrhythmias
What are the effects of mitral insufficiency?
valve prolapse may cause valvular regurgitation - blood leaks back into the left atrium instead of out the aorta
What is aortic stenosis?
narrow aortic valve - decreases SV and CO - causes hypertrophy in LV, which increases myocardial oxygen demand
What are the three main causes of aortic stenosis?
Birth defect in aortic valve - usually has three cusps but can have only one or two.
Rheumatic fever can also cause stenosis here.
Age-related valve degeneration.
Infective endocarditis
