Valvular Disease Flashcards Preview

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Flashcards in Valvular Disease Deck (25)
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1
Q

functional regurgitation

A

incompetence due to disruption of supporting structures

(as in aorta root dilation, left ventricle dilation)

2
Q

damage caused by wear and tear complicatedby deposits of calcium phosphate

A

dystrophic calcification

3
Q

clinical effects of calcific aortic stenosis

A

LV increased pressure casues hypertrophy

angia, ischemia, CHF

syncope

4
Q

morphology of calcified aortic stenosis

A

calicified masses in cusps, primarily at base

no fusion of commissures

5
Q

mitral annular calcification

A

degenrative calicific dposits on fibrous ring at base of valve,

usually doesn’t impact function

thrombis possible

6
Q

mxyomatous degeration of mitral valve (prolapse)

A

enlarged leaflets, prolaps into left atrium during systole

(mid-systolic click)

7
Q

complciations of mxomatous mitral valve

A

late systolic murmor,

rare: endocarditis, mitral insufficiency, thrombi, arrhythmias

8
Q

most serious complication of RA

A

progression to chronic vavlular dysfxn (mitral stenosis)

9
Q

classic lesion of RA

A

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

caterpillar cells

10
Q

pancarditis of RA

A

bread and butter pericardiits

myocarditis w/ aschoff bofdies

subendochondrail maccullum plaques (fibrous thickening of endocardium)

11
Q

chonic RA >chronic inflammatior and fibrosis leads to -

A

thickened leaflets

fusion of commisures

thickening/fusion of chordae tendinae

12
Q

clinical impact of chronic RA

A

mitral stenosis > atrial dilatation > reduced output

13
Q

pathogenesis RA

A

hypersensitivity induced by Group A Strep >

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

>protein in sarcolemma of myocyte

14
Q

Jones criteria of RA

A

Joints

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

Nodules

Erythema marginatum of skin (trunk)

Sydenham chorea

15
Q

protein produced by group A stresp

A

Steptolysis O and DNAase

16
Q

2 forms of ineffective endocarditis

A

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

subacute - low virulance with deformed valve, responds to AB

17
Q

common organisms of Ineffective Endocardits

A

Strep viridans (50-60%)

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

18
Q

acute inefective endocarditis morphology

A

friable destructive vegetations

inflammatory cells and bacteria, fibrin

triscuspid valve in IV users

ring abcesses in erosion of myocardium

19
Q

differing factors in subacute ineffective endocarditis

A

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

20
Q

clinical features of Bacterial endocardiits

A

Dukes criteria

blood culture, valve related mass, abcesses

new vale regurgiation, new murmur on auscultation

Minor: fever, predisposing heart lesion of IVDA

21
Q

complciations bacterial endocarditis

A

valve insuf

myocaridal abcesses > perforation

vegetations embolize (kidneys, spleen)

glomulonephritis (immune complexes)

22
Q

pathogenesis of non-iffective vegetations- non bacterial thrombotis endocarditis

A

hypercoag. state

mucin producing adenocarcinomas

endocardial trauma (swan-ganz catherter)

23
Q

morphology liban sacks endocarditis

A

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

posible intense inflammation

24
Q

carcinoid syndrome- - tumors produce

A

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

25
Q

presentation carcinoid syndrome

A

flushing, cramps, nausea, vomiting, diarrhea

plaqaue like fibrosis of heart endocardium, usually right heart

(becsaue of inactivation of mediators by MAO in lung)