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Flashcards in Hemodynamic Disorders II Deck (34):
1

second most common valvular disease causing hemodynamic disorder

Calcific aortic stenosis

2

Three main causes of Calcific aortic stenosis

congenitally anomalous bicusid valve
Senile degeneration
Chronic rheumatic disease

3

The cause of CAS in most patients under 65 is:

bicuspid valve

4

The cause of CAS in most patients over 65 is:

senile degeneration

5

Symptoms of CAS

Angina pectoris (chest pain due to myocardial ischemia), syncope, dyspnea
Symptoms usually occur with exertion.

6

Surgical valve replacement improves survival

truth

7

Early pathology of CAS

Thickening with lipid deposition and inflammation (macrophages and lymphocytes) followed by some fibrosis.

8

Late pathology of CAS

Nodular heaped up calcifications

9

What is mitral valve regurgitation.

Well, the mitral valve is between the left atrium and left ventricle so Mitral regurgitation is when , during systolic contraction, some of the blood from the left ventricle goes back into the left atrium when the valve doesn't work properly.

10

Most common cause of mitral regurgitation

Mitral valve prlapse....followed by ischemic heart disease.

11

Pathophys consequences of mitral regurgitation are?

Decreased forward stroke volume
Increased left atrium volume and pressure
Volume related stress on the left ventricle because the added left atrial volume is returned to it along with the normal left atrial volume during diastole

12

Flash pulmonary edema

When rupture of a papillary muscle due to an MI or IE causes sudden mitral regurgitation, increasing left atrial pressure which is then transmitted backwards to the pulmonary circulation, may cause rapid pulmonary edema which is called flash pulmonary edema. MEDICAL EMERGENCY

13

Acute mitral regurg symptom

dyspnea

14

Chronic mitral regurg symptom

fatigue

15

Forward stroke volume from normal of 100ml down to 75 is what

Heart failure

16

Mitral valve prolapse maybe associated with connective tissue disorders like Marfans

True

17

Most common valvular disease?

MVP

18

Rheumatic Heart DIsease

A "pancarditic" (endo, myo, and epi cardium) disease of inflammation following pharyngitis caused by group A Beta hemolytic strep.

19

Gross pathology of ARF

Tiny vegetations lined up where the valves close

20

Microscopic pathology

Fibrin and platelett thrombi on valves, and aschoff bodies

21

Whats an Aschoff Body

foci of fibrinoid necrosis with histocytes anitschkow cells.

22

Chronic Rheumatic Heart Disease is more common with:

Recurrent carditis, carditis at an early age, or severe carditis

23

Surgical valve replacement leads to the requirement of lifelong anti-coagulants

True

24

Libman-Sacks Endocarditis

Associated with Lupus. 50% of pts. Usually occurs simultaneously with pericarditis. Can feature vegetations (flat or berrylike) on all valves though mitral and tricuspid are most common.

25

Marantic Endocarditis

Nonbacterial thrombotic endocarditis. Its common and occurs in 75% of patients with malignant tumors. Its basically the deposition of blood clot on heart valves and can be a PRECURSOR TO IE.

26

Marantic endocarditis is also prevalent in pts with what?

DIC, sepsis, and swan-ganz heart catheterization

27

Pathology of Marantic Endocarditis

small fibrin and platelet thrombi most commonly on the atrial side of the mitral valve.

28

Pathogeneisis of Infective endocaditis

valvular injury, platelet and fibrin deposition, microbial seeding, microbial multiplication

29

Three classifications of IE

Acute bacterial vs. subacute bacterial (Acute = Aureus, subacute= viridians streptococci),

30

Prosthetic valve endocarditis is commonly due to what organism

Staph epidermis

31

Pathology of IE

Large friable vegetations that are some combination or tan, red, gray, brown.

32

Common physical signs of IE

fever, heart murmur,petechiae, splenomegaly

33

Common symptoms:

Fever, weakness dyspnea

34

Common lab findings in IE

elevated ESR, circulating immune complexes, anemia, proteinura.