Aortic & Pulmonary Valve Disease

Question 1

Describe the Aortic Valve anatomy and function

Answer 1

1. Tri leaflet 2. Allows blood flow from the LV into the aorta 3. Prevents backflow during diastole

Question 2

What is the difference between a True and Functional Bicuspid AV valve?

Answer 2

True: 2 coronary sinuses and 2 leaflets

Functional: 3 sinues and 2 of 3 leaflets fused together

Question 3

What other conditions are associated with Bicuspid AV?

Answer 3

1. Aortic Stenosis (~75%)
2. Aoritic insufficiency (regurgitation) (~25%)
3. Aortic dilation
4. Endocarditis

Question 4

True or false:

Bicuspid AV causes a weakening of the Aortic root.

Answer 4

True:

This is why Aortic dilation, dissection and aneurysms form with bicuspid AV.

Question 5

True or False:
A patient has bicuspid AV valve. His family should be screened as well.

Answer 5

True: it is an autosomal dominant disorder.

Question 6

What is the basic mechanism of Aortic Stenosis? Where does it come from?

Answer 6

Decreased aortic valve opening. The LV works harder to eject blood

Question 7

What are the causes of Aortic stenosis?

Answer 7

1. Congenital (bicuspid)
2. Calcific
   
   • occurs in elderly
3. Rheumatic (occurs with MV disease)

Question 8

What are the symptoms of Aortic Stenosis?

Answer 8

1. Dyspnea on exertion
2. Exertional Angina
3. Exertonal Lightheadedness or syncope

Question 9

True or False:

Patients that are Asymptomatic Aortic stenosis have better survival rates than symptomatic pts.

Answer 9

True

Worry once they become symptomatic

Question 10

What is the hallmark sound for aortic stenosis?

Answer 10

A murmur that crecendos and then decrecendos. the later the decrecendo the more severe.

Question 11

What happens in Aortic insufficiency(regurgitation)?

Answer 11

Valves dont close properly and blood flows back into the LV.

Causes LV dilation, Systolic dysfunction, and HF

Question 12

What is the etiology of aortic insufficiency(regurgitation)?

Answer 12

Valvular disease

• Bicuspid AV
• Aortic Stenosis (calcific, endocarditis, rheumatic)

Aortic Disease

• Disection
• Marfan’s
• Aneurysm/dilation

Question 13

When does the murmur occur in Aortic Insufficiency (regurgitation)? How does the legnth relate to severeity?

Answer 13

Occurs during Diastole

Longer the murmur, more severe the problem

Question 14

What are the treatments for Aortic Insufficiency? When is surgery indicated?

Answer 14

Treat CHF symptoms if present

To Surgery: Development of Symptoms, LV dilation or dysfunction. Of if surgery is being done for anything else.

Question 15

What is the presentation of a patient with Pulmonary stenosis?

Answer 15

All the symptoms of RHF.

Question 16

True or false:

The most common form of pulmonic valve stenosis is endocarditis

Answer 16

False:

It is usually diagnosed in children or teenagers due to congenital defects.

Question 17

A patient comes in and recieves an Echo. The echo shows a pulmonary insufficiency. Should you be worried? What most likely caused it?

Answer 17

Mild-Moderate PI is common and is not usually worrysome if asymptomatic.

Usially PIs are caused by previous surgery (ie ballooning other valves)

Question 18

What is the theme as far as treating valvular diseases?

Answer 18

Treat symptoms with meds, then do baloon valvoplasty or replace the valve.