Valvular Heart Disease Flashcards Preview

Cardiology > Valvular Heart Disease > Flashcards

Flashcards in Valvular Heart Disease Deck (36)
Loading flashcards...
1

What are the role of the semilunar valves?

aortic and pulmonary; maintain unidirectional flow

2

What are the AV valves?

mitral and tricuspid

3

Where do the AV valves attach to the wall?

free margins attached to ventricular wall via chordae tendinae and papillary muscls

4

What is valvular stenosis?

failure of a valve to open completely; usually a chronic process affecting a valve cusp

5

What is insufficiency of valvular heart disease?

failure to close completely;
functional regurgitation: valvular incompetence due to disruption of supporting structures; -aorta root dilation-left ventricle dilation
and
intrinsical disease of valve cusps

6

What are the major causes of valvular disease?

congenital causes (bicuspid aortic valve-most common)
aquired causes
(stenosis of aortic valve, insufficiency of aortic valve: dilation of ascending aorta related to HTN and aging)
MItral valve (stenosis: rheumatic heart disease
Insufficiency: myxomatous degeneration)
Stenoses are more frequent than insufficiencies

7

What is calcific valvular disease?

dystrophic calcification, damage caused by wear and tear complicated by desposits of calcium phosphate
distinct from atherosclerosis

8

What are the clinical effects of calcific valvular disease?

LV: increased pressure causes hypertrophy
-angina, ischemia and CHF
-syncope
-CHF often leading to death within two years

9

HOw do you treat clacific aortic stenosis?

valve replacement

10

What are the symptoms, relation of mitral annular calcification?

in women greater than 60 years old, usually doesn't affect function but site for thrombi /infection

11

What are the role of myxomatous degeneration of mitral valve prolapse?

very common; 3% adults, young women, usually no complications and fx of marfan and other hereditary disorders

12

What ar ethe clinical fx of myxomatous mitral valve?

asymptomatic with mid systolic click
complication suncommon but infective endocarditis, mitral insufficiency, thrombi on atrail surface, arrythmias and sudden death

13

Wha tis the most important complication of rheumatic fever?

progression to chronic valvular dysfunction, mitral stenosis

14

What is the morphology of acute rheumatic fever?

pancarditis (affect all 3 layers)
pericaritis
myocarditis with aschoff bodies
endocarium and left sided valves with fibrinoid necrosis
sunbendocardial plaques

15

What is an aschoff body?

foci of swollen eosinophilic collagen, surrounded by T lymphocytes, plasma cells and plump macrophages

16

What is the pathogenesis of rheumatic heart disease?

hypersensitivity rxn inducd by group a strep
antibodies against M protein cross react with glycoprotein antigens in heart
genetic susceptibility

17

What is the infective endocarditis morphology?

acute and subacute endocarditis, friable large bluky vegetations
fibrin and inflammatory cells
mitral valve and aortic valve common site
may cause ring abscess

18

What is the duke criteria?

bacterial endocarditis;
major:
positive blood culture
echocardiographic findings
new valve regurgitation
minr:
predisposing heart lesion
fever
uncommon finding resulting from septic emboli

19

What are the complications of baacterial endocarditis?

valvular insufficiency or stenosis
myocardial abscess and possible perforation
vegetations break off
glomerulonphritis

20

What is nonbacterial thrombotic endocarditis?

depositions of small masses of fibrin platelets and other blood products on leaflet

21

What is libman-sacks endocarditis?

non-infectve vegetations
SLE; primary antiphospholipid syndrome
may have intense inflammation

22

What is carcinoid heart disease?

cardiac manifestation of carcinoid tumor
505 OF PATIENTS WITH CARRINOID SYNDROME PLAQUE LIKE FIBROSIS OF RIGHT HEART ENDOCARDIUM AND VALVES

23

What are the complicationss of artifical valves?

thromboembolic complications
infective endocarditis


i bioprothesis
structural deterioration
infective endocarditis

24

What do you see on physical exam of aortic stenosis?

sustained LV impulse, no LV displacement
pulsus parvus et tardus of the carotid impulse
absent A2 or paraoxically split A2
murmur is systolic cresendo

25

What are the mean survival rates of aortic stenosis pts from different symptoms?

angina->5yrs
syncope->3yrs
CHF->2yrs

26

What ar ethe causes of aortic regurgitation?

congenital
endocarditis
rheumatic
dilation of aortic root including anuerysm, inflammation, dissction, symphilis

27

What is the presentation of aortic regurgitation?

dyspnea on exertion
fatiue
decrease excercie tolerance
chest pain
hyperdynamic pulse
widened pulse pressure

28

What is the treatment of aortic regurgiation?

acute--> surgical emergency
chronic severe
asymptomatic with normal LVEF - periodic echos and reduce afterload
asymptomatic and low LVEF or symptomatic and normal LVEF ---> surgery and valve replacemet

29

What are the causes o mitral valve regurgitation?

myxomatous disease (MVP)
rhemuatic vlave
endocarditis
ceft leaflet(Congenital)

ischemic CM
dilated CM
hypertrophic CM

30

What is the physical cause associated with all of the causes of mitral valve regurgitationa functionally?

volume overload state
which is well tolerated until severe; when seere regurgitation develops slowsly