VHD patho Flashcards
(25 cards)
What’s VHD?
Any disease involving one or more of the cardiac valves. They may be congenital or acquired.
What’s the cause of mitral stenosis?
The most common is rheumatic endocarditis (found in the rheumatic fever).
The pathogenies of MS?
Fibrous fusion of the valve cusps causing decreased diameter of mitral
orifice (Normally; it is 25-30 mms).
What cause Mitral regorge?
Rheumatic endocarditis
Myocardial ischemia
Myxomatous degeneration of the mitral cusps.
Functional dilatation of the valve ring
What cause the aortic stenosis?
Rheumatic endocarditis.
Calcific atherosclerosis.
Congenital stenosis (valvular or subvalvular???).
What cause the aortic regorge?
- Rheumatic endocarditis
- Syphilitic aortitis (Dilatation of the root of aorta and aortic ring).
- Congenital malformed aortic valve (as Bicuspid aortic valve).
- Myxomatous degeneration of the cusps
occurs in case of:
a) Marfan’s syndrome. b) Ankylosing spondylitis
What cause marfan’s syndrome?
genetic dominant trait of C.T. synthesis.
What are the C/P of marfan?
The patients are unusually tall &thin having long limbs & long thin fingers.
What are the complications of marfans
Aortic incompetence and aortic aneurysm.
Effects on eyes, hard palate, lungs, dura surrounding the spinal cord, and skeleton.
What is ankylosing spondylitis?
Chronic inflammatory disease of the spine with involvement of peripheral joints and
non-articular structures.
What cause of tricuspid stenosis?
Rheumatic endocarditis:
Carcinoid syndrome (Carcinoid valvular endocarditis)
Realising of serotonin» right side of heart»fibrosis thickening and stenosis» affect endo lining the inner of my-cardial
What cause the Tricuspid regorge?
Functional dilatation of tricuspid valve ring
Rheumatic endocarditis
Atypical verrucous endocarditis associated w SLE
What cause the pulmonary stenosis?
The opposite of aorta
Congenital
Carcinoid (for right side)
RE rare
What cause the PI?
Functional dilatation of the valve ring; 2ry to severe pulmonary hypertension. ?????
Atypical verrucous endocarditis: seen in SLE
Rheumatic endocarditis (Rare)
Congenital valve deformity (Rare).
What’s the commonest affected valve in rheumatic VHD?
mitral valve only and 2nd combined mitral & aortic
Rare in the right side of the heart
What happened in earliest lesions of R VHD?
Fibrinoid necrosis يبدأ C.T tissue يتقطع ويتحول إلى فايبرين
الجسم يعامل الفايبرين على أساس انه جسم غريب ويبدا يشغل الجهاز المناعي
antibody complexes are deposited in the BV walls along with fibrin
of the valvular C.T.) راح تسبب oedema & infiltration by lymphocytes, plasma, macrophages & PNLs مهمة النيتروفيل
How about the later and late in RVHD?
Later: Destruction of the valvular endothelium + formation of
vegetations كثيرة صغيرة ناشفة لازقة شكل قرنبيط متكونة من platelets & fibrin
Late:healing by fibrosis
What’s the two type of (non) rheumatic VHD?
acute and subacute infective endocarditis
The affected valve of AIE?
Any intact valve اهم شيء يكون سليم
Describe the gross of AIE?
Vegetations on valvular endocardium characterized by: 1. Large. 2. Polypoid. 3. Friable.
What you see in LM of AIE?
The endothelium ulcerated >infiltrated by acute inflammatory cells> vegetations فيها كل شيء ومن ضمنها ال high virulent bacterial colonies مثل الستاف وهذا الشيء راح يسبب formation of pus> no granulation مافي فرصة انه يتعافى> acute sudden damage> acute heart failure and sudden death
The affected valve of subacute?
Any previously diseased (e.g. by rheumatic fibrosis) or congenitally
malformed valve.
The gross pic of subacute?
Vegetations on valvular endocardium characterized by: 1. Large. 2. Polypoid. 3. Friable.
LM of subacute?
chronic rheumatic valvulitis but together with low grade bacteria
Vegetations> granulation tissue> gradual damage> chronic HF and treatable condition
