8.4 - Valvular disorders Flashcards
acute rheumatic fever is due to what organism family?
group A beta-hemolytic strep
what is the etiology of acute rheumatic fever?
molecular mimicry - bacterial M protein resembles proteins in human tissue
how is diagnosis of acute rheumatic fever made?
JONES criteria:
- joints (polyarthritis)
- heart (pancarditis)
- nodules (subcutaneous)
- erythema marginatum
- sydenham chorea
endocarditits in acute rheumatic fever leads to what sequalae?
small vegetations lead to regurgitation
what is the most common cause of death during acute rheumatic fever?
myocarditis
what are aschoff bodies? when / where are they seen?
- foci of chronic inflammation
- myocarditis phase of acute rheumatic fever
what are anitschkow cells? when / where are they seen?
- reactive histiocytes with slender, wavy nuclei
- myocarditis phase of acute rheumatic fever
how is erythema marginatum in acute rheumatic fever described?
annular, nonpruritic rash with erythematous borders, commonly involving trunk and limbs
what is the main complication of chronic rheumatic disease?
endocarditis
aschoff bodies and anitschkow cells are seen in what condition?
acute rheumatic fever
what are the complications of aortic stenosis?
- concentric LVH
- angina and syncope with exercise
- microangiopathic hemolytic anemia (production of schistocytes)
what RBC variant is produced as a result of aortic stenosis?
schistocyte
early, blowing, diastolic murmur
aortic regurgitation
is the pulse pressure increased or decreased in aortic regurgitation?
increased
water hammer pulse - diagnosis?
aortic regurgitation
how does aortic regurgitation present?
- head bobbing
- water hammer pulse
- pulsating nail bed (quincke pulse)
aortic regurgitation results in what type of hypertrophy? why?
- eccentric hypertrophy
- volume overload
mid-systolic click followed by a regurgitation murmur
mitral valve prolapse
the click and murmur of mitral valve prolapse become softer with what movement?
squatting (increased systemic resistance decreases LV emptying
holosystolic “blowing” murmur
mitral regurgitation
mitral regurgitation (holosystolic “blowing” murmur) gets louder with what movements?
- squatting (increased systemic resistance decreases LV emptying)
- expiration (increased return to LA)
opening snap followed by diastolic rumble
mitral stenosis
what are the sequalae of mitral stenosis?
volume overload leads to dilation of LA:
- pulmonary congestion
- pulmonary HTN
- atrial fibrillation
