Stenosis caused by valvular heart disease is caused by a failure of the valves to completely close thereby allowing regurgitation of blood
False, this is Insufficiency
Stenosis = narrowing/failure to open causing obstruction of forward flow
what sound can be heard when there is turbulent flow through a diseased valve?
Murmur
what are thrills?
turbulence caused by severe lesions that can be palpated
What is the most common cause of aortic valve stenosis
calcific aortic stenosis
- causes a decrease in cardiac output and an increase in left ventricular contraction
Fusion of the heart valves is common in calcific aortic stenosis
False, fusion is rare
What causes rheumatic valvular disease
Group A Beta Hemolytic Streptococcal Phayngitis
What age group is Rheumatic Valvular disease most common in
5-15 year olds
What valve is involved in 70% of Rheumatic Valvular Disease
Mitral
What is a major defining characteristic of Acute Rheumatic heart disease
Aschoff Bodies
What are some symptoms associated with Rheumatic Valvular Disease
1) Fever
2) Carditis -
3) Migratory Polyarthritis (Arthritis jumps from 1 joint to another)
4) Sydenham’s Chorea (uncontrolled muscle contraction)
5) Subcutaneous skin rash
6) Abnormal ECG
Which symptoms of rheumatic valvular disease is most often seen in children? Adults?
Children - Carditis
Adults - Arthritis
Symptoms of rheumatic valvular disease begin how long after streptococcal infection?
2-3 weeks
Subacute Infective Endocarditis is destructive, virulent and difficult to treat as compared to acute infective endocarditis which is low in virulence and easy to treat
False, Backwards
Acute - destructive/hard to treat
Subacute - low virulence and easy to treat
In which type of Infective endocarditis are the valves previously Normal
Acute
( In subacute they are previously abnormal tissue)
the most common cause of infective endocarditis is becteremia
true
50-60% of cases of endocarditis occur on damaged or deformed valves caused by __________ organism. By contract the more virulent _________ organism can attack deformed as well as healthy valves and is responsible for 10-20% of cases.
Strep. Viridans ( Subacute - on damaged valves, less virulent)
Staph Aureus (Acute - on healthy valves, more virulent)
Prosthetic Cardiac Valves are prone to infection
True, involved in 20% of all infective endocarditis cases
Primary Cardiomyopathies are the result of a disorder in the myocardium itself, and Secondary cardiomyopathies are caused by some other systemic disorder
true
90% of cadiomyopathy cases are from which group:
Dilated, hypertrophic or restrictive?
Dilated
Dilated Cardiomyopathy is characterized by progressive cardiac chamber dilation and Diastolic Dysfunction
False, Systolic (contractile) Dysfunction
Alcohol abuse and Beri Beri are associated with which group of Cardiomyopathy
Dilated
which group of cardiomyopathy causes 1/3 of sudden cardiac death in young athletes
Hypertrophic
The fundamental defect in Dilated Cardiomyopathy is ineffective contraction thus leading to ejection fraction less than 25%
True
Which group of cardiomyopathy is is associated with a flabby poorly contractile heart?
Dilated cardiomyopathy
Which group of cardiomyopathy is associated with asymmetrically thick heavy walls and a hyper-contractile heart (won’t relax) with an elongated “banana-like” ventricle
Hypertrophic Cardiomyopathy
Hypertrophic Cardiomyopathy is a genetic disorder involving B-myosin mutations
True
- causes hypercontractile sarcomeres
This form of Cardiomyopathy is the least common and is associated with impaired ventricular filling due to a stiff myocardium
Restrictive
Non-Viral infections are the most common cause of Myocarditis
False, Viral
Infection and Inflammation targeting the myocardium is called _______
myocarditis
Myocarditis can be viral and non-viral
True
Viral (MC) - Coxsackievirus A and B, HIV, CMV, Influenza
Non-Viral - Lyme, Chagras, SLE, ADR’s
Primary Pericarditis is Most common and often due to a viral infection
False, Is rare - usually secondary to MI, Cardiac surgery etc.
Pericarditis typically manifests with which symptoms?
Atypical Chest Pain and Prominent Friction Rub
What is the name of the most common primary tumor to the adult heart?
Myxoma
Myxomas are a single malignant lesions found on/near the fossa ovalis (left atrium) 90% of the time
False, Benign
What is the most common primary malignant tumor to the heart
Angiosarcoma
which type of cancer most commonly metastasizes to the heart
Lung Cancer
Without transplantation, 20% of those with heart failure will die within 1 year
False, 50%
What is the most common long term limitation of heart transplant
Allograft Arteriopathy - rapid stenosis of coronary arteries
- 5 years = 50% have lesions
- 10 years = 100% have lesions
