aortic and pulmonic disease Flashcards
valve diseases in hospital discharge most to least prevalent
- mitral
- aortic
- Rheumatic MR
- mitral stenosis/endocarditis
valve disease: surgical procedures: most to least prevalent
- all valve replacement
- AV
- All MV
- MV
factors responsible for the development of calcific aortic stenosis
- atherosclerosis risk factors
- genetic
- osteoblast phenotype
aortic valve is open in
diastole
closed in systole
types of aortic valve
- bicuspid
- rheumatic
- calcific
bicuspid
congential, where two cups have fused.
only 2 commissures instead of 3
calcific
deposits of calcium in the leaflets and restricts the motion.
rheumatic
commissures fuse an then calcify
characterization of early lesion of degenerative vavular aortic stenoisisl
classify early vs late based on:
displacement of elastic lamina and mineralization
survival of pt with aortic stenosis over time: onset of symptoms
- around 60 yrs old
- angina
- syncope
- failure
aortic valve replacement
mechanical or bioprosthesis
Once thought a degenerative disease, the mechanism by which a healthy tricuspid aortic valve becomes stenotic is now believed to be
similar to that of atherosclerosis.
The tricuspid aortic valves become stenotic in the
sixth, seventh, and eighth decades of life, mainly caused by calcium deposits in the valve cusps and not by fusion of the commissures.
In developed countries, _____ has become a very rare cause of aortic stenosis.
rheumatic fever
When the aortic valve is affected by rheumatic heart disease the mitral valve is almost always affected as well.
Valve replacement is recommended for
individuals with symptomatic severe aortic stenosis.
Such patients have a dire outlook, with 75% dying within 3 years of symptom onset.
The cardinal symptoms of severe aortic stenosis are
- angina
- syncope and
- shortness of breath
The bicuspid aortic valve is the
most common congenital cardiac malformation, occurring in 1% to 2% of the population.
The majority of BAV patients develop complications eventually requiring treatment.
After development, BAV is associated with
- aortic dilation
- aneurysms, and
- dissection .
In light of this, the BAVs should be considered a disease of the entire aortic root.
Bicuspid valve: The elastic laminae of the aortic media
In patients with BAV, deficient microfibrillar elements result in smooth muscle cell detachment, matrix metalloproteinases (MMPs) release, matrix disruption, cell death, and a loss of structural support and elasticity.
Complications of bicuspid aortic valve
- valvular complications
2. vascular complications.
bicuspid: valvular complications
- Aortic stenosis
- Aortic Insufficiency
- Endocarditis
