Valvular heart disease Flashcards Preview

Year 3 Human Disease > Valvular heart disease > Flashcards

Flashcards in Valvular heart disease Deck (40):
1

name and locate the heart valves

-atrioventricular valves: tricuspid (right), Mitral (left)
-pulmonary (right atrium --> pulmonary artery)
-aortic (left atrium --> aorta)

2

2 main types of valvular heart disease

-valvular stenosis: narrowing of valve orifice --> limits amount of blood flowing through
-valvular incompetence: failure of non-return function --> valvular regurgitation

3

2 main consequences of valvular heart disease

-reduction in CO (--> exercise intolerance, left ventricular hypertrophy --> left ventricular failure, sudden death)
-infection eg infective endocarditis

4

4 types of left heart valvular disease

-mitral stenosis
-mitral reguritation
-aortic stenosis
-aortic regurgitation

5

describe mitral stenosis and risk factors 2

thickening of valve leaflets with calcification and closure of commisures
occurs with age related calcification, rheumatic heart disease

6

is rheumatic heart disease often a cause for valvular heart conditions? why?

not in UK. yes in developing world. associated with poor nutrition and overcrowding

7

3 complications of mitral stenosis and symptoms of each

-heart failure: oedema, breathlessness, blue discolouration
-atrial fibrillation: 'fluttering atrium' --> clot risk --> stroke
-infective endocarditis

8

risk factors for mitral regurgitation 5

-rheumatic heart disease
-bacterial endocarditis
-mitral valve prolapse (2-5% of UK population have this)
-ischaemic heart disease --> rupture of papillary muscle/ chordae tendonii
-cardiomyopathy (enlargement of heart muscle)

9

compliations of mitral regurgitation 3

same as mitral stenosis:
-heart failure: oedema, breathlessness, blue discolouration
-atrial fibrillation: 'fluttering atrium' --> clot risk --> stroke
-infective endocarditis

10

risk factors for aortic stenosis 3

-congenital bicuspid valve
-degenerative calcification
-rheumatic heart disease

11

consequence on heart of aortic stenosis

obstruction to left ventricular flow

12

causes of aortic regurgitation 8

-rheumatic heart disease
-hypertension
-syphilis
-Marfan's syndrome
-Ehler's Danlos syndrome
-osteogenesis imperfecta
-idiopathic aortic root dilation
-endocarditis

13

Pathophysiologically, what can cause aortic regurgitation other than valve dysfunction

incompetence or dilation of aortic root

14

describe symptoms of Marfan syndrome and faulty gene which causes it

Fibrillin 1 gene
tall, elongated head, wide forehead, high arch palate, retinal problems
enlarged aorta and floppy valves --> aortic aneurysm

15

2 types of right heart valvular disease

tricuspid stenosis
tricuspid regurgitation

16

most common cause of tricuspid stenosis/ regurgitation

rheumatic heart disease

17

other causes of tricuspid regurgitation

RHD, congenital heart disease, endocarditis secdonary to IV drug abuse --> VALVULAR ENLARGEMENT

18

what causes rheumatic heart disease

acute rheumatic fever (occurs 2-3 weeks after group A streptococcal infection in throat)

19

age group at risk of rheumatic heart disease

5-15yo

20

pathology of cardiac complications of rheumatic heart disease

strep A infection (throat)
--> antibodies made in lymph nodes
--> antibodies against strep A also attack body's own cells eg in endocardium, where they cause vegetations to form on valvles
= ANTIBODY CROSS REACTIVITY

21

4 areas of rheumatic fever effects and examples of each

-heart: pericarditis, myocardititis, endocerditis
-joints: flitting polyarthritis
-skin: subcutaneous nodules and skin rashes (erythema marginatum)
-arteries: arteritis

22

name and describe the histological hallmark

Aschoff body. contents 3:
-swollen eosinophilic collagen
-macrophages
-lymphocytes

23

long-term effects of rheumatic fever

>95% recover completely
BUT 10-15% have chronic scarring of mitral valve cusps over 50 yrs --> thickened valve cusps, fuses commisures of cusps --> mitral stenosis

24

define infective endocarditis (IE)

acute or chronic disease resulting from infection of focal area of endocardium

25

what part of the heart does IE involve? explain

usually heart valve, but could also be:
-mural endocardium of atrium or ventricle
-congenital defect eg patent ductus arteriosis or co-arctation of aorta

26

2 types of IE and which bacteria causes each, %

-acute: S. aureus. (40%) destructive infection of often healthy heart valve with highly virulent organism
-subacute: S viridans (60%). insidious disease of previously abnormal valve with less virulent organism

27

why is IE relevant to dentistry?

s aureus and s viridans found in oropharynx --> bacteremia can cause IE

28

where in body are IE organisms found? 5

-oropharynx
-resp tract
-skin (+ candida)
-GI tract
-Urinary tract

29

what bacteria is common in large intestine and outcome of it

strep faecalis
causes UTI

30

how are bacteria from GI/U tracts spread around body

during cystoscopy or prostatectomy

31

clinical presentation of IE 4

-cardiac disease
-infection --> fever, malaise
-embolism (bacteria build up on valves then break away)
-immunological phenomena

32

name and describe lesions of IE

vegetations
bacterial colonies and thrombotic debris (platelets, fibrin, bacteria)

33

most common sites for IE and %

95% on left side heart valves (mitral, aortic). most of these in previously damaged valves

34

pathogenesis of IE

(endothelial lining of heart and its valves is normally resistant to infection with bacteria and funghi)
endothelial injury --> platelets and fibrin --> secondary infection by distant source of infection or transient bacteraemia

35

potential complcations of IE

-stroke
-skin patches
-spleen: infarction, abscess
-kidney: infarction, homaturia
-eye: roth spots
-fingernails: splinter haemorrhage
-hands: Janeway lesions

36

oral side effects of
a. anticoagulants
b. calcium channel blockers

a. anticoagulants: bleeding risk
b. calcium channel blockers: gingival hyperplasia

37

what drugs cause oral drug interactions? 3

beta blockers
ACE inhibitors
diuretics

38

symptoms of oral drug interactions?

tongue: white striae, red discolouration

39

risk of endocarditis with
a. dental extraction
b. toothbrushing
c. chewing

a. dental extraction: 51-85%
b. toothbrushing: 0-26%
c. chewing: 17-51%

40

what bacteria causes 60% of IE

strep viridans