[13] Pathology of Valvular Heart Disease

Question 1

Define: Valvular Insufficiency

Answer 1

Failure to Close Completely

Question 2

Cause of Valvular Insufficiency

Answer 2

Abnormal Cusp/Leaflet

Abnormal Surrounding/Supporting Structures

Question 3

Bacteria that causes Rheumatic Fever

Answer 3

Group A B-Hemolytic Streptococcus

Question 4

Arrange in Order of Frequency of Valves affected in RHD

Aortic Valve
Mitral Valve
Pulmonary Valve
Tricuspid Valve

Answer 4

MV > AV > TV > PV

Question 5

Both MV and AV are affected in what % of patients?

Answer 5

33%

Question 6

Prosthetic Heart Valves are notorious for causing?

Answer 6

Infective Endocarditis

Question 7

Vegetations of Infective Endocarditis are more common on?

Answer 7

Left-Sided Cardiac Valves

Question 8

[T/F]

Thrombotic vegetations of Infective endocarditis can be seen in intimal surfaces of systemic/pulmonary arteries or veins

(c/o Sia, Silava, Solis)

Answer 8

True

Question 9

Causes of IE

c/o Sia, Silava, Solis

Answer 9

1. Turbulent blood flow

2. Entry of microorganisms and adherence to thrombus

Question 10

Conditions associated with IE in normal heart valves?

c/o Sia, Silava, Solis

Answer 10

1. Intravenous drug users

2. Immunocompromised hosts

Question 11

Most common predisposing condition for bacterial endocarditis in children

(c/o Sia, Silava, Solis)

Answer 11

Congenital Heart Disease

Question 12

[T/F] Vegetations are more common in right sided cardiac valves?

(c/o Sia, Silava, Solis)

Answer 12

F

Left sided cardiac valves

Question 13

Clinical Symptoms of Bacterial IE

c/o Sia, Silava, Solis

Answer 13

Fever, Anemia, Systemic embolization, CHF, Murmur, Vegetations/destruction of valves of ECG, Positive blood culture

Question 14

Local Complications of Bacterial IE

c/o Sia, Silava, Solis

Answer 14

Valvular Stenosis/Heart Murmur
Acute Heart Failure
Aneurysm
Local Sepsis

Question 15

Systemic Complications

c/o Sia, Silava, Solis

Answer 15

Bacteremia
Embolization of Thrombus Infarction/ischemia
Abscess Formation
Infective Vasculitis
Mycotic Aneurysm

Question 16

Valve most commonly singly affected by non-bacterial thrombotic endocarditis

(c/o Sia, Silava, Solis)

Answer 16

AV Valve

Question 17

Most striking cardiac lesion in SLE

c/o Sia, Silava, Solis

Answer 17

Libman-Sacks Verrucous Vegetations

Question 18

Description of IE Vegetations

c/o Sia, Silava, Solis

Answer 18

Bulky, friable lesions on the valve

Question 19

Description of NBTE Lesions

c/o Sia, Silava, Solis

Answer 19

Small/medium red/tan vegetations attached at the line of closure of the valve leaflets

Question 20

Description of vegetative lesions found in SLE?

c/o Sia, Silava, Solis

Answer 20

Small/medium vegetations on either or both sides of the valve leaflets

Question 21

Order of Valves Most Commonly Affected by Valvulitis

c/o Sia, Silava, Solis

Answer 21

Mitral > Aortic > Tricuspid > Pulmonic

Question 22

Complications of CRHD

c/o Sia, Silava, Solis

Answer 22

Bacterial Endocarditis
Mural Thrombi
CHF
Adhesive Pericarditis

Question 23

In Mitral Regurgitation, cusps can become

c/o Sia, Silava, Solis

Answer 23

Perforated
Retracted
Expanded

Question 24

In Mitral Regurgitation, chordae can become

c/o Sia, Silava, Solis

Answer 24

Short or Long

Question 25

In Mitral Regurgitation, a dilated ring signifies

c/o Sia, Silava, Solis

Answer 25

Marfan’s Disease