Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Physiology > Lecture 14: Cardiac valve disorders > Flashcards

Lecture 14: Cardiac valve disorders Flashcards

1
Q

Pathophysiology of aortic regurgitation - PV loop

A

Low pressure filling

Tremendous preload, diastolic volume doubles

Filling is prolonged (filling from two spots)

Big stroke volume

Slightly enhanced contractility

See figure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What happens to semilunar valves during ventricular systole?

A

Opening of semilunar valves

Ventricles contract and force the valves to open by pushing blood through

See figure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Aortic valve

A

See figure

Systole: cusps forced open

Diastole: blood gets caught in valves, and they close

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of murmur occurs in mitral regurgitation

A

Holosystolic high pitched murmur extending from S1 to S2

Constant intensity throughout

Heard best at the apex, often radiates to the left axilla

Exaggerated with exertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What might you hear in the lungs in a person with mitral stenosis?

A

Rales (crackles)

Due to fluid getting pushed into the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Etiology of mitral stenosis

A

1) Most commonly occurs a decade after rheumatic fever.
2) Calcification.
3) Congenital.
4) Rarely occurs with lupus (autoimmune) or rheumatoid arthritis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sound of murmur in aortic stenosis

A

Harsh and rough

Crescendo and decrescendo

If the valves ares still malleable, an early ‘clink’ will be heard

A fourth heart sound (S4) is common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What happens if heart failure is present in mitral regurgitation?

A

Third heart sound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Symptoms of aortic stenosis

A

1) Angina Pectoris (chest pain): Increased demand for coronary blood due to hypertrophy and afterload. Compression of coronary vessels and the aortic ‘jetstream’ have also been implicated.
2) Syncope (fainting): Due to decreased cerebral flow.
3) Congestive heart failure: Due to persistent afterload.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why do palpitations occur in people with mitral stenosis?

A

Usually the results of atrial arrhythmias, such as atrial fibrillation.

The enlarged atrium is the major risk for this, which occurs due to the high atrial pressure.

Dilated atria = electrical path length is longer than usual = increased chance that something will go wrong with transmission of electrical current

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does aortic stenosis cause?

A

Systolic murmur

Increased pressure required by LV = myocardial hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Symptoms of aortic regurgitation?

A

Shortness of breath

LV is preloaded from the LA and the aorta = increased volume load on the heart

Pressure builds up in the lungs

Pulmonary congestion and edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Aortic regurgitation anatomy

A

Retracted fibrotic valve cusps = incompetent aortic valve

Dilated and hypertrophied left ventricle (eccentric hypertrophy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Symptoms of mitral stenosis

A

1) Shortness of breath, hemoptysis (coughing of blood or blood stained mucous from respiratory system), and orthopnea (shortness of breath when lying flat)
2) Palpitations
3) Neurological symptoms:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Other physician findings in aortic regurgitation

A

Widened pulse pressure with hyperdynamic pulses.

Pulsating carotid impulses and nailbeds, sometimes uvula.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is another word for mitral prolapse? When is it diagnosed?

A

Floppy mitral valve

Often diagnosed in adulthood, since manifestations can take years to manifest.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where is a murmur from aortic best heard?

A

Base of the heart (2nd ICS)

Can project up the carotid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What determines blood flow in the heart?

A

Changes in pressure

Cause valves to open and close

Blood moves from high pressure to low pressure (gradient)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are cardiac murmurs? Cause?

A

Abnormal sounds created by the heart.

Can be caused by pericardial rub, fluid overload (due to renal or heart failure), and valve disease (most common)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What can result if a valve failures to close?

A

Regurgitation

Incompetency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why do neurological symptoms occur in people with mitral stenosis?

A

Usually the result of embolic events caused by the atrial arrhythmias.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Pathophysiology of mitral regurgitation - PV loop

A

Ventricle gets dilated, filled with same blood

Big preload (EDV)

Big filling curve

Isovolumetric filling and contraction are lost

See figure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What kind of murmur does mitral valve prolapse produce?

A

Presents as mid-systolic clicks, or late systolic murmur.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is valve stenosis?

A

Valve fails to open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What characteristics are common in left-sided murmurs?
Pulmonary congestion and dyspnea
26
Symptoms of mitral regurgitation
1) Shortness of breath, orthopnea, nocturnal dyspnea: Due to pulmonary congestion and edema. 2) Palpitations: Atrial enlargement predisposes to atrial arrhythmias.
27
How to know if aortic regurgitation has lead to heart failure?
Third heart sound
28
What happens to AV valves during diastole?
Opening of the AV valves Blood returning to the heart travels through the atria and forces the AV valves open The atria contract forcing addition of blood into the ventricles See figure
29
Pathophysiology of mitral stenosis - wiggers lewis
Higher LA pressures Separation between pressures during diastole
30
Type of murmur in mitral stenosis
Diastolic rumble over the apex Worsened after exertion May have opening snap
31
Aortic Stenosis anatomy
Valve can be either a tricuspid aortic valve that has thickened and become stenotic, or a bicuspid valve, which results from the fusion of two leaflets of the valve during development Hypertrophy of left ventricle (concentric hypertrophy) Post-stenotic dilation of ascending aorta Calcified aortic valve See figure
32
What causes valve disorders?
Infection Post-infection Inflammatory disorders Ischemic disorders Congenital disorders
33
Eitology of mitral regurgitation
1) Acute causes: rupture of a chordae or damage to a papillary muscle from ischemia, trauma, or infective endocarditis. 2) Rheumatic heart disease. 3) Myxomatous degeneration (ie. Mitral valve prolapse). 4) Calcification of the annulus. 5) Congenital
34
Pathophysiology of aortic stenosis: Wiggers-Lewis
Big separation of LV pressure and aortic pressure (LV pressure needs to increase to get the blood through the stenotic aortic valve) Shortening of pulse pressure QRS complex is wider (hypertrophy) Phonocardiogram shows systolic murmur
35
What is the Gallaverdin phenomenon?
If aortic stenosis is heard at the apex of the heart, it can be confused with mitral regurgitation
36
What causes shortness of breath, hemoptysis and orthopnea in people with mitral stenosis
Backpressure to the lungs is very severe, which elevates pulmonary capillary pressures.
37
Pathophysiology of mitral stenosis - PV loop
Can't get blood into the ventricle = restricted filling
38
Rheumatic aortic stenosis - how?
Fibrosis and calcification following a strep infection
39
Pathophysiology of mitral regurgitation - wiggers lewis
High LA pressure Aortic pressure is normal See figure
40
Possible etiologies of aortic stenosis
Congenital Rheumatic Degenerative
41
What is the ethology of aortic regurgitation?
Cups abnormalities: Endocarditis, Rheumatic disease (post infection), Ankylosing spondylitis (systemic inflammatory disease), Congenital malformation Aortic disease: Aneurysm (blood filled bulge on a vessel), Marfan’s (genetic disease in which connective tissue deteriorates around the aorta and the valve opens), Systemic inflammatory disease, Trauma, Dissection
42
Phonograms for common murmurs
See figure
43
Valve anatomy
See figure
44
Anatomy of mitral stenosis
Small mitral orifice (cusps calcified together) Atria are not strong enough to push blood through the valve = atria dilate Enlarged thickened left atrium Small left ventricle Thickened matted chordae tendinae See figure
45
Where do valve disorders often occur?
Occur more frequently on the left side of the heart Right valve disorders occur in people who use IV drugs (bacterial deposits)
46
Congenital aortic stenosis - anatomy of valve, when does it present?
Unicuspid or bicuspid valve Can present early in life or in 5th-6th decade
47
What do valve disorders result from
If there is failure of a valve opening or closing
48
What does mitral valve prolapse lead to?
Occasionally, MVP causes symptomatic regurgitation which increases the risk of infective endocarditis and requires surgical repair.
49
Degenerative aortic stenosis - how? when? Risk factors?
Calcification of a valve Usually in 7th decade of life Risk factors are the same as atherosclerosis
50
Wiggers/Lewis diagram
Illustrates the relationship between cardiac pressures, volumes, ECG and heart sounds throughout the cardiac cycle See figure
51
Types of artificial valve replacements
1) caged ball valve 2) tilting disc valve 3) single leaflet valve 4) bileaflet valve See figure
52
Anatomy of mitral regurgitation
Incompetent mitral valve Retracted shortened mitral valve cusps Enlarged left atrial appendage Ruptured chordae tendinae Enlarged left ventricle Enlarged left atrium
53
What type of murmur in aortic stenosis? When does it occur?
Systolic murmur Begins after S1 and ends before S2
54
What happens to AV valves during ventricular systole?
Closing of AV valves Ventricles contract, forcing blood against AV valves AV valves close (first heart sound) Papillary muscles contract to stabilize the valves See figure
55
What kind of murmur does aortic regurgitation produce
Diastolic murmur in aortic area Sometimes at apex (austin flint murmur) Described as blowing and often faint
56
Where is the apical impulse in a person with mitral regurgitation?
Laterally displaced and hyper dynamic
57
What does aortic regurgitation cause?
Diastolic murmur Increased volume load on LV = dilation
58
How is mitral valve prolapse diagnosed?
Often diagnosed by echocardiogram before symptoms.
59
Pathophysiology of aortic stenosis: PV loop
Hypertophied LV Curve is shifted up, the heart is filling under higher pressure Loop is more narrow (ventricle is hard to fill) Need to generate big pressure during isovolumetric contraction Not as much blood is injected into the aorta, so the end systolic volume is higher Shift in contractility due to SNS stimulation See figure
60
Pathophysiology of aortic regurgitation - wiggers Lewis
Diastolic pressure in aorta is low (ejected blood is leaking back into atria) Widening of pulse pressure Phonocardiogram: diastolic murmur (always), sometimes accompanied by small systolic murmur
61
What happens to semilunar valves during diastole?
Closing of semilunar valves Ventricles relax, intraventricular pressure falls and blood flows back from the arteries, filing the cusps of the semilunar valves, forcing them to close See figure

Physiology (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions