4.4 Overview of Cardiac Valve Disease

Question 1

what are the 3 types of valve disease?

Answer 1

Narrowing: stenosis
Leak: regurgitation
Both: mixed valve disease, stenosis and regurgitation

Question 2

What changes will you see with stenosis?

Answer 2

Increase in pressure needed to get blood across
thickening of chamber behind the valve
Increase in pressure in the veins behind the valve
Pressure gradient across the valve

Question 3

What changes will you see with valve regurgitation?

Answer 3

Volume load for the chamber behind the valve

later there will be venous engorgement in pulmonary or systemic veins (or both)

Question 4

What are the causes of valve disease?

Answer 4

Congenital 
Rheumatic 
Infective 
Degenerative 
Secondary to other heart or vessel disease

Question 5

Symptoms of left valve problems

Answer 5

Dyspnoea which increases over years - but can occur suddenly
Exertional chest tightness or syncope - aortic stenosis

Question 6

Symptoms of right valve problems

Answer 6

Oedema 
fatigue 
dyspnoea 
cyanosis 
uncommon unless congenital

Question 7

What is the best investigation for valve problems?

Answer 7

Echo (with doppler)