Heart Valve Disease Flashcards
(34 cards)
Define valvular heart disease
Damage to or a defect in one or more of the four heart valves
What are the four valves in the heart?
Mitral - LA to LV
Aortic - LV to Aorta
Tricuspid - RA to RV
Pulmonary - RV to Pulmonary aa
What are the main causes of valvular heart disease?
Congenital
Rheumatic
Degenerative
Cardiac remodelling
Infective endocarditis
Describe congenital VHD
VHD (valvular heart disease) caused by a congenital defect -Aortic stenosis is commonly due to calcification of a congenital bicuspid (mitral) aortic valve
Describe rheumatic VHD
Damage to connective tissue of heart valves caused by rheumatic fever
-mitral/tricuspid/aortic stenosis
(Rheumatic fever = an immune disorder that occurs in children, usually following tonsillitis/pharyngitis caused by group A B-haemolytic strep (GAS))
Describe degenerative VHD
Progressive process of slow degeneration
-mitral/tricuspid
Describe cardiac remodelling VHD
Cardiac remodelling can lead to VHD
- hypertrophy/dilatation leading to regurg
- raised pressure causing stenosis
Describe how infective endocarditis can cause VHD
Heart valves not directly supplied with blood, hard to fight infection
- Collagen exposure; thrombus development in the short term with post-inflammatory scarring leading to long-term functional impairment
- left sided valves more frequently affected
Describe the difference between stenotic and regurgitation valvular disease
Stenosis - narrowing of a valve opening causing lowered blood flow
Regurgitation - blood flows back through valve after leaflets close
What are the main causes of mitral stenosis?
Rheumatic heart disease
What are the main sx/signs of mitral stenosis?
Sx - Dysnpoea, haemoptyis, palpitations (AF), RHF - cor pulmonale (LA unable to empty leading to pulmonary HTN)
Signs - Malar flush, JVP, left parasternal heave
Describe the murmur of mitral stenosis
Low pitched diastolic murmur
-heard loudest at apex
What are the main causes of mitral regurgitation?
- Endocarditis
- Papillary muscle rupture
- post MI
- LV dilation (LVF, HOCM)
- Mitral prolapse
What are the main sx/signs of mitral regurgitation?
Sx - Palpitations (AF), dyspnoea/orthopnoea, RHF/CCF
Signs - Displaced apex beat, systolic thrill
What are the main causes of aortic stenosis?
Calcification of aortic valve
Rheumatic fever
Congenital bicuspid (most common)
What are the main sx/signs of aortic stenosis?
Sx - Angina, exercise induced syncope/dyspnoea
Signs - Small volume, slow rising carotid, narrow pulse pressure, systolic thrill
Describe the murmur of aortic stenosis
Ejection systolic crescendo-decrescendo murmur
-in aortic area, radiates to carotids
Describe the murmur of mitral regurgitation
Pansystolic murmur
-at apex, radiating into axilla
What are the main causes of aortic regurgitation?
Infective endocarditis
Age-related calcification
Dilation of aortic root (syphilis, AS)
What are the main sx/signs of aortic regurgitation?
Sx - Asymptomatic until LVF, angina, dyspnoea
Signs - Bounding/collapsing pulse, wide pulse pressure, LVF
Describe the murmur of aortic regurgitation
Diastolic decrescendo murmur
What non-invasive tests can be used to assess the heart valves?
ECG
CXR
Echo
What is the treatment for Mitral Stenosis?
Treat any AF
Diuretics - Reduce pre-load/congestion
Surgical - Balloon valvuloplasty/valvotomy
What is the treatment for Mitral Regurgitation?
Treat AF
Treat heart failure
Surgery
