Flashcards in Valvular Heart Disease & HTN Deck (14)
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1
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
2
Name the most common form of hypertension
Essential HTN
- idiopathic
3
What are the effects of chronic hypertension on the appearance and function of the heart?
Hypertrophy and/or dilation of the heart
4
Define cor pulmonale
Right heart failure
5
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)
6
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)
7
Identify the most common causes of aortic stenosis in (a) patient 70 years old.
a)
b)
8
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
9
List several complications of rheumatic heart disease.
- Valves can't open or close (stenosis, regurg)
- Can progress to HF
- Susceptible to infective endocarditis
10
Name the most commonly affected valves in rheumatic heart disease.
Mitral (65-75%)
Aortic, usually with MV (25%)
11
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
Infectious endocarditis:
- 1ary infection of normal/damaged valve
- Causes: bacteria (skin, oral, GI), fungi, viruses
12
List examples of the bacteria commonly associated with infectious endocarditis
- S. aureus
- Strep. viridans
13
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.
a
14