2B: Pathology of Heart Valve Disease Flashcards
What is S2?
The second heart sound is “shorter” and usually higher frequency than S1– indicates the end of ventricular systole and beginning of ventricular diastole.
***CLOSURE OF the SEMILUNAR VALVES
What is S1?
The first heart sound & associated w/ closure of the mitral valve & tricuspid valves at the onset of ventricular contraction
What is S3?
The 3rd Heart sound is associated with the rapid passive filling phase of ventricular diastole
What is S4?
The 4th Heart sound is associated w/ ATRIAL CONTRACTION
What are heart murmurs? and their cause?
- Abnormal heart sounds because of VALVE PROBLEMS
- When heart strikes obstructions, flow becomes turbulent.
- Common in YOUNG CHILDREN (& Some elderly)
- Cause? Heart walls are THIN and vibrate w/ rushing blood.
What are Incompetent heart murmurs?
Hear the swishing sound
What are Stenotic Heart Murmurs?
Hear the high pitch or click
What is a valvular stenosis?
When a valve does not open properly
What is Valvular regurgitation/ Incompetence/ insufficiency? And end result of valve dysfunction?
-When a valve does not close properly resulting in BACK-FLOW (regurgitation) of blood.
End result of valve dysfunction? MYOCARDIAL HYPERTROPHY
***(mechanism intended to increase the pumping capability of the heart)
When does Valvular heart disease occur ?
- As a result of rheumatic fever, may be secondary to various other inflammatory processes
- occurs with prosthetic valves (can be the site of thrombus formation or infectious endocarditis)
What is Rheumatic Fever?
-Multisystem inflammatory disorder w/ major cardiac manifestations & sequelae, most often affecting children ( 5 & 15 yrs)
*****Occurs 1-4 weeks after an episode of tonsillitis or other infections caused by group A Beta hemolytic strep.
-Can lead to endocarditis—> valvular damage
Which valve is most commonly involved w/ Rheumatic heart disease?
Mitral valve
What is rheumatic heart disease
?
Late sequelae, occurring many years after the episode of rheumatic fever, are grouped under the term rheumatic heart disease
What is Mitral Stenosis?
Impairment of blood flow from the L. atrium to the left ventricle;
Result:
1) LESS VENTRICULAR FILLING
2) Decreased SV and CO
What are the clinical manifestations of Mitral Stenosis?
Increased LA pressure & hypertrophy, LV hypertrophy, and increased risk of atrial dysrhythmias
What are the causes of Mitral Stenosis?
1) Rheumatic Fever
- limits valves ability to open and close
- may have mitral valve stenosis and regurgitation
2) Congenital heart defect
- narrowed mitral valve & develops stenosis early.
- Heart surgery required
What is Mitral Insufficiency (PROLAPSE)?
*****Some blood ejected during ventricular systole is forced into the L. atrium (instead of the aorta). Blood is leaking in the wrong direction.
Result: decreased SV and CO, increased LV hypertrophy
-MOST frequent heart valve problem
What are the causes of Mitral Insufficiency (PROLAPSE)?
1) Rheumatic fever
2) Infective endocarditis
3) Wear an tear on the valve
4) Prior heart attack
5) Untreated high BP
6) Congenital Heart defects
What is AORTIC Stenosis?
- Diminished blood flow from the left ventricle into the aorta
- Results: Decreased SV and CO also faint pulses
- LV hypertrophy(thick wall) develops which increases myocardial oxygen demand
What are the main causes of Aortic Stenosis?
1) Birth defects of aortic valve
2) Defective valve– only 1 cusp (should have 3)
3) A bicuspid aortic valve w. progressive wear & tear
2) Rheumatic heart disease
3) Age related degenerative change
What is degenerative calcific aortic stenosis?
- Occurs with persons older than 60.
- Normal aortic valve as an age related degenerative change
What is aortic insufficiency?
BLood ejected during Ventricular Systole flows back into L. ventricle during ventricular diastole
- Increased ESV, decreased SV and CO and LV hypertrophy.
What are cause of aortic insufficiency?
1) congenital heart defect
2) deterioration of the valve w/ age
3) infective endocarditis
4) rheumatic fever
