Valvular Heart Disease Pathology

Question 1

How can hypertension affect the Left Ventricle? How does it do this?

Answer 1

causes concentric hypertrophy
additional sarcomeres/myofibrils are added to existing cardiomyocytes.
can also cause dilation of the heart.

Question 2

What do we see in microscopic evaluation of hypertrophied tissue?

Answer 2

boxcar fibers. Note that there are the same number of myocytes. Only we see increased number of sarcomeres

https://www.google.com/search?q=boxcar+fibers+hypertrophied+tissue&rlz=1C1LENN_enUS488US488&espv=2&biw=1517&bih=692&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjKm8a2i-_LAhXltoMKHW7VC7cQ_AUIBigB&dpr=0.9#tbm=isch&q=boxcar+nuclei+hypertrophied+tissue&imgrc=nglX4kSddqn63M%3A

Question 3

What are major complications of hypertension?

Answer 3

atherosclerosis/aneurysm

• kidney disease
• congestive heart failure

Question 4

What is a common cause of right heart failure?

Answer 4

left Heart failure

Question 5

Pulmonary Hypertension affects _______

Answer 5

right ventricle

Question 6

Right heart failure that arises NOT as the cause of left heart failure is usually what?

Answer 6

Cor pulmonale. This is associated with pulmonary hypertension which usually arises as some sort of hypoxia (sleep apnea etc..)

Question 7

So what is Cor Pulmonale?

What are major causes?

Answer 7

pulmonary and thoracic causes of right heart failure.
Causes- pulmonary vessel disease (stuff getting stuck in vessels), emphysema (hypoxia), chest movement alterations (hypoxia), etc…

Question 8

Right Heart failure can lead to what problem in the liver?

Answer 8

nutmeg liver- blood pooled in the sinusoids of the liver.

Question 9

What is the prevalence of bicuspid aortic valve disorder. More males or females?

Answer 9

prevalence- (0.5%-2.0%)

more males than females

Question 10

What are complications of bicuspid aortic valve disorder?

Answer 10

• reduced outflow leading to ventricular hypertrophy

- increased turbulence leading to valve thickening, stenosis, calcification etc..

Question 11

Abnormal valves are usually either _____ or ______ and show increased susceptibility to what?

Answer 11

stenosis
regurgitation/insufficiency

-nodular calcification, vegetation formation, infection

Question 12

What is the most common cause of mitral regurgitation?

Answer 12

Mitral Valve prolapse

Question 13

What genetic condition is often associated with mitral valve prolapse?

Answer 13

Marfan’s syndrome

Question 14

what are the most common causes of aortic calcific stenosis in:
-people 70 yrs of age

Answer 14

• most commonly arises with an underlying valve abnormality (i.e. bicuspid or bioprosthetic valve).
• most commonly involves a normal valve

Question 15

What is pancarditis with respect to rheumatic fever?

Answer 15

inflammation in any layer of the heart 10 days-6 weeks after pharyngitis.

Question 16

What is the major manifestation of chronic rheumatic heart disease?

Answer 16

mitral and aortic valve disease

Question 17

What findings do we see in valve leaflets and cusps in rheumatic heart disease?

Answer 17

thickening

Question 18

what findings do we see in chordae tendinea in rheumatic fever?

Answer 18

thickening, shortening, fusing- makes the valve less flexible

Question 19

Buzzword for rheumatic fever?

Answer 19

fish-mouth stenosis on valves

Question 20

What are the two major classes of cardiac valve vegetations?

Answer 20

infectious and non-infectious

Question 21

what are complications of endocarditis?

Answer 21

septic emboli- plugs stuff up and spreads bugs everywhere. compromised valve function.

Question 22

difference between acute and subacute endocarditis?

Answer 22

acute eats away valves (highly virulent)

subacute has a more insidious onset and is more indolent.