Flashcards in Valvular Heart Disease & HTN Deck (14)
Describe the microscopic appearance of the myofibers in the setting of cardiac myocyte hypertrophy.
- Enlargement of myocytes
- No additional myocytes created
- you do get more sarcomeres, myofibrils
Name the most common form of hypertension
What are the effects of chronic hypertension on the appearance and function of the heart?
Hypertrophy and/or dilation of the heart
Define cor pulmonale
Right heart failure
Give examples of underlying causes (excluding left heart failure) of cor pulmonale
- Pulmonary parenchyma disease (emphysema, institial lung disease, bronchiectasis)
- Pulmonary Vessel Disease (PE, 1ary pulm HTN, sleep apnea)
- Chest movement alterations (kyphoscoliosis, obesity, neuromuscular)
Discuss the incidence and long term implications of a bicuspid aortic value.
1 in 50-100 people
Asymptomatic until later in life with accelerated wear and tear
- Reduced outflow => ventricular hypertrophy
- Increased turbulence => valve thickening & stenosis (BIGGEST problem)
Identify the most common causes of aortic stenosis in (a) patient 70 years old.
Describe the key features of rheumatic heart disease with respect to the valve leaflets, chordae tendinae, and the effects on the functionality of the valve.
VL: fibrosis, fusion, calcification
CT: fibrosis, fusion, shortening
Leads to stenosis and regurgitation
List several complications of rheumatic heart disease.
- Valves can't open or close (stenosis, regurg)
- Can progress to HF
- Susceptible to infective endocarditis
Name the most commonly affected valves in rheumatic heart disease.
Aortic, usually with MV (25%)
Distinguish the two major classes of cardiac valve vegetations and their causes.
Non-bacterial thrombotic endocarditis:
- thrombus formation in valve
- No organism involved
- Causes: RHD, SLE, hypercoag state
- 1ary infection of normal/damaged valve
- Causes: bacteria (skin, oral, GI), fungi, viruses
List examples of the bacteria commonly associated with infectious endocarditis
- S. aureus
- Strep. viridans
Describe the propensity of bacteria commonly associated with infectious endocarditis to infect normal versus abnormal valves and how the bacteria may gain access to the valves.