Valvular Disease Flashcards Preview

Cardiovascular > Valvular Disease > Flashcards

Flashcards in Valvular Disease Deck (25):
1

functional regurgitation

incompetence due to disruption of supporting structures 

(as in aorta root dilation, left ventricle dilation)

2

damage caused by wear and tear complicatedby deposits of calcium phosphate

dystrophic calcification

3

clinical effects of calcific aortic stenosis

LV increased pressure casues hypertrophy

angia, ischemia, CHF

syncope

4

morphology of calcified aortic stenosis

calicified masses in cusps, primarily at base

 

no fusion of commissures

5

mitral annular calcification

degenrative calicific dposits on fibrous ring at base of valve,

 

usually doesn't impact function

thrombis possible

6

mxyomatous degeration of mitral valve (prolapse)

enlarged leaflets, prolaps into left atrium during systole

(mid-systolic click)

7

complciations of mxomatous mitral valve

late systolic murmor, 

rare: endocarditis, mitral insufficiency, thrombi, arrhythmias

8

most serious complication of RA

progression to chronic vavlular dysfxn (mitral stenosis)

9

classic lesion of RA

aschoff body - swollen eosinophillic collogen surroudned by t lymphocytes, plasma, and plump macrophages.

 

caterpillar cells

10

pancarditis of RA

bread and butter pericardiits

myocarditis w/ aschoff bofdies

subendochondrail maccullum plaques (fibrous thickening of endocardium)

11

chonic RA >chronic inflammatior and fibrosis leads to - 

thickened leaflets

fusion of commisures

thickening/fusion of chordae tendinae

12

clinical impact of chronic RA

mitral stenosis > atrial dilatation > reduced output

13

pathogenesis RA

hypersensitivity induced by Group A Strep >

> Abs against Mm proteins cross react to glycoproteins inheart, joints >

>protein in sarcolemma of myocyte

14

Jones criteria of RA

Joints

Heart (carditis, weakened heart sounds, tachy, arrhythmia)

Nodules

Erythema marginatum of skin (trunk)

Sydenham chorea

15

protein produced by group A stresp

Steptolysis O and DNAase

16

2 forms of ineffective endocarditis

acute - virulent organism, normal valve, (or necrotizing infection needing surgery)

 

subacute - low virulance with deformed valve, responds to AB

17

common organisms of Ineffective Endocardits

Strep viridans (50-60%)

Staph A (10-20%) (most common in all IVDA)

18

acute inefective endocarditis morphology

friable destructive vegetations

inflammatory cells and bacteria, fibrin

triscuspid valve in IV users

ring abcesses in erosion of myocardium

19

differing factors in subacute ineffective endocarditis

less valvular destruction, fibroiss and granulation tissue reaction at base of vegetaion

20

clinical features of Bacterial endocardiits

Dukes criteria

blood culture, valve related mass, abcesses

new vale regurgiation, new murmur on auscultation

Minor: fever, predisposing heart lesion of IVDA

21

complciations bacterial endocarditis

valve insuf

myocaridal abcesses > perforation

vegetations embolize (kidneys, spleen)

glomulonephritis (immune complexes)

22

pathogenesis of non-iffective vegetations- non bacterial thrombotis endocarditis

hypercoag. state

mucin producing adenocarcinomas

endocardial trauma (swan-ganz catherter)

23

morphology liban sacks endocarditis

1-4 mm verrucae with fibrinous material on leaflets and pos endocardium

 

posible intense inflammation

24

carcinoid syndrome- - tumors produce

carcinoid tumors produce serotonin, kallifkrein, brady kinin, histamine, prostagalndins, tachykinins

 

25

presentation carcinoid syndrome

flushing, cramps, nausea, vomiting, diarrhea

 

plaqaue like fibrosis of heart endocardium, usually right heart

(becsaue of inactivation of mediators by MAO in lung)