AORTIC/PULM VALVES

Question 1

Aortic Valve Pathology can be

Answer 1

• normal
• “bicuspid” (BAV)
• calcific
• rheumatic

Question 2

Aortic Sclerosis

Answer 2

increases in prevalence w/ age

Question 3

Aortic Stenosis

Answer 3

increases in prevalence w/ age

Question 4

calcification is a condition in which calcium deposits form on the aortic valve in the heart. These deposits can cause narrowing at the opening of the aortic valve. This narrowing can become severe enough to reduce blood flow through the aortic valve, a condition called _____________

Answer 4

aortic valve stenosis.

Question 5

________- is defined as calcification and thickening of a trileaflet aortic valve in the absence of obstruction of ventricular outflow.

Answer 5

Aortic valve sclerosis

Question 6

Factors responsible for the development of calcific aortic stenosis

Answer 6

Atherosclerotic
Genetic
“Osteoblast phenotype”

Question 7

Once thought a degenerative disease, the mechanism by which a healthy tricuspid aortic valve becomes stenotic is now believed to be similar to that of __________

Answer 7

atherosclerosis.

Question 8

The tricuspid aortic valves become stenotic in the sixth, seventh, and eighth decades of life, mainly caused by _____________ and not by fusion of the commissures

Answer 8

calcium deposits in the valve cusps

Question 9

In developed countries, rheumatic fever has become a very rare cause of aortic stenosis.

When the aortic valve is affected by __________ the mitral valve is almost always affected as well.

Answer 9

rheumatic heart disease

Question 10

The ____________ of the aortic valve serves as the mainstay of diagnosis.

Answer 10

echocardiogram with Doppler interrogation

Question 11

____________ is recommended for individuals with symptomatic severe aortic stenosis.

Answer 11

Valve replacement

Such patients have a dire outlook, with 75% dying within 3 years of symptom onset

Question 12

The cardinal symptoms of severe aortic stenosis are:

Answer 12

angina
syncope
shortness of breath

Question 13

The ___________ is the most common congenital cardiac malformation. Males are affected 4:1

Answer 13

bicuspid aortic valve (BAV)

AD: Echocardiographic screening of first-degree relatives is warranted.

Question 14

(BAV) bicuspid aortic valves result by abnormal aortic cusp formation during valvulogenesis.

_________ fuse to form a single aberrant cusp, larger than its counterpart yet smaller than 2 normal cusps combined.

Answer 14

Adjacent cusps

Question 15

BAV is associated with _________________. In light of this, the BAVs should be considered a disease of the entire aortic root.

Answer 15

aortic dilation
aneurysms
dissection

Question 16

Complications of Bicuspid Aortic Valve

Valvular Complications

Answer 16

Aortic stenosis
Aortic Insufficiency: Cusp prolapse
Endocarditis

Question 17

Complications of Bicuspid Aortic Valve

Vascular Complications

Answer 17

Aortic dilation
Aneurysm formation
Aortic dissection
Asociations: Coarctaction, PDA, Coronary anomalies

Question 18

Management of Bicuspid Aortic Valve

Answer 18

serial echocardiography at regular intervals

Question 19

Bicuspid aortic valve disease is the most common congenital cardiac defect, often associated with dilation of the proximal ascending aorta secondary to abnormalities of the ___________.

Answer 19

aortic media

Question 20

Aortic Regurgitation

Answer 20

condition that occurs when your heart’s aortic valve doesn’t close tightly. Aortic valve regurgitation allows some of the blood that was just pumped out of your heart’s main pumping chamber (left ventricle) to leak back into it.

Question 21

Aortic Regurgitation

Valve disease

Answer 21

Rheumatic
Degenerative
Endocarditis
Congenital
Bicuspid
Quadricuspid

Question 22

Aortic Regurgitation

Disease of the aorta

Answer 22

Dissection
Marfan’s
Atherosclerosis
Annulo-aortic ectasia
Syphilis
Ankylosing spondilitis
Osteogenesis imperfecta

Question 23

Rapid forceful carotid upstroke followed by rapid decline

Answer 23

Corrigan’s pulse

Signs of Aortic Regurgitation

Question 24

Diastolic blanching in nail bed when slightly compressed

Answer 24

Quincke’s pulse

Signs of Aortic Regurgitation

Question 25

Systolic and diastolic femoral bruits when compressed with stethoscope

Answer 25

Durozie’z sign

Signs of Aortic Regurgitation

Question 26

Systolic BP in legs > 30 mmHg than in arms

Answer 26

Hill’s sign

Signs of Aortic Regurgitation

Question 27

valve that influences the blood flow from heart to lungs slows the blood flow. Adults occasionally have the condition as a complication of another illness, but mostly develops before birth as a congenital heart defect.

Answer 27

Pulmonic Stenosis

Question 28

Stenosis of the pulmonic valve is one of the more common _________ Most of the patients are children however may come to attention during adolescence or adulthood.

Answer 28

forms of congenital heart disease.

Question 29

In recent years ______________ has largely replaced surgical valvotomy except in patients with dysplastic valves.

Answer 29

percutaneous balloon valvuloplasty