Valvular Heart Disease, Endocarditis Flashcards
(53 cards)
Is valvular heart disease primary or secondary ?
It can be both.
What proportion of heart failure involve valve disease ?
10% of heart failures involve valve disease
Which valves of the heart are affected by valvular disease ?
All four, but mainly aortic and mitral valve
Give an example of how valvular heart disease could occur secondary to another event.
Dilatation of the heart causing an inability for the valve to close.
Identify the main function of heart valves.
To allow forward flow but prevent backflow.
Identify the main components of valves.
Valve ring
Cusps
Chordae
Papillary muscle (mitral and tricuspid only)
Identify the main functional failures in valves.
Mitral stenosis
Mitral incompetence
Aortic stenosis
Aortic incompetence
Although aortic and mitral valve disease are more common than pulmonary and tricuspid valve disease, are they also more serious ?
Yes, more common and more serious
Are stenosis and incompetence mutually exclusive ?
No, stenosis and incompetence can coexist (but even if they’re both involved, one might be dominant)
Why are pulmonary and tricuspid valves less likely to be affected/why is it less severe in those valves ?
Less involved because under less mechanical stress which also means that any disease affecting the valve is likely to be made much worse in mitral/aortic valve (hence more severe)
Define stenosis.
Narrowing of the valve outlet caused by thickening of valve cusps, or increased rigidity or scarring.
Define incompetence.
Insufficiency or regurgitation (which is what happens) caused by incomplete seal when valves close, allowing blood to flow backwards
Define vegetations and explain their relevance to valvular heart disease.
“any plantlike growth”
Something growing in a valve (typically platelets and fibrin thrombus, sometimes can be calcified scar tissue)
Which phase of the cardiac cycle would you notice aortic incompetence in ?
Diastole
Which phase of the cardiac cycle would you notice aortic stenosis in ?
Systole
Which phase of the cardiac cycle would you notice mitral stenosis in ?
Diastole
Identify general, common causes of cardiac valve stenosis and incompetence.
1) Congenital Heart Disease
- Bicuspid valve (When it should in fact have three cusps. Can be problematic) e.g. in aorta
- Atresia
2) Cardiomyopathy
- Hypertrophic
- Dilated
3) Acquired
- Rheumatic fever
- MI
- Age-related- idiopathic aortic calcific stenosis
- Endocarditis
Which valvular functional failure would a dilated cardiomyopathy result in ?
Incompetence, because the valvular ring would be dilated, so cusps cannot meet anymore
Which valvular functional failure would a hypertrophic cardiomyopathy result in ?
Stenosis or incompetence.
What are the possible risks of aortic stenosis ?
- L ventricular hypertrophy (L ventricle has to push harder)
- Syncope (loss of consciousness)
- Sudden cardiac death
Identify causes of aortic stenosis.
- Calcification of congenital bicuspid valve
- Senile calcific degeneration
- Rheumatic fever (inflammatory holes in cusps resulting in scarring and stenosis)
Identify consequences and clinical symptoms of aortic stenosis.
- Increases work of the heart
- Ventricular hypertrophy
- Causes cardiac failure late in clinical course
Clinical symptoms include:
- Dyspnoea (breathlessness)
- Angina (cardiac chest pain)
- Syncope
Identify the main causes of aortic incompetence.
- Infective endocarditis
- Rheumatic fever
- Marfan’s syndrome (CT too elastic)
- Dilatation of aortic root (age-related or syphilitic)
What are the consequences of aortic regurgitation ?
Increases V of blood to be pumped
Increases work to be done by the heart
Cardiac Hypertrophy
Cardiac Failure
