Aortic/Mitral Valvular Disease Flashcards
What are the 2 criteria for Left sided Hypertensive Disease?
- Concentric LV hypertrophy
2. Other evidence of hypertension
With Left sided Hypertensive Disease, describe what can be seen with the diastolic and systolic dysfunctions
Diastolic dysfunction - atrial enlargement/fibrillation
= Thromboembolism risk
Systolic dysfunction - increased oxygen requirement
Cor pulmonale
Right sided Hypertensive Disease
Describe how Right sided Hypertensive Disease (cor pulmonale) arises
- Vasoconstriction in the lungs
- Increased Pulmonary A. Pressure
- Increased RV pressure
= Right sided Heart Failure
Left Sided Hypertensive Disease results in?
Congestive Heart Failure
What are the risk factors for Calcific Aortic Stenosis?
Increasing age (60-80) with chronic HTN and hyperlipidemia
Calcific Aortic Stenosis
Mounded calcifications in cusps of valve prevent complete opening
All heart valves besides the mitral valve should have how many cusps?
3
Congenital or acquired fusion can cause Bicuspid Aortic Valves…. what will this show an accelerated course of?
Calcific Aortic Stenosis 1-2 decades earlier than usually expected
Congenital or acquired fusion can cause Bicuspid Aortic Valves… what will this show an accelerated course of?
Calcific Aortic Stenosis 1-2 decades earlier than usually expected
What are the possible symptoms of Calcific Aortic Stenosis?
LV hypertrophy
Systolic murmur
Angina and syncope
Congestive Heart Failure
What are the possible symptoms of Calcific Aortic Stenosis?
LV hypertrophy
Systolic murmur
Angina and syncope
Congestive Heart Failure
Who/Where are Mitral Annular Calcifications?
- Females older than 60
= Calcific deposits in fibrous annulus (base of leaflets)
Who/Where are Mitral Annular Calcifications?
- Females older than 60
= Calcific deposits in fibrous annulus (base of leaflets)
What do Mitral Annular Calcifications lead to?
Arrhythmias –> heart block and sudden death
Mitral Valve Prolapse
Valve leaflets prolapse back into left atrium during systole
– Hooding of the leaflets is seen
What syndrome is Mitral Valve Prolapse common?
Marfan Syndrome
What are the signs of Mitral Valve Prolapse?
Mid-systolic click
Dyspnea
ALL valvular abnormalities seem to be associated with an increased risk for?
Infective Endocarditis
ALL valvular abnormalities seem to be associated with an increased risk for?
Infective Endocarditis
Describe how Rheumatic Fever arises
- Group A Streptococcus Pharyngitis
- Antibodies to M streptococcal protein
- Reactive to self antigens in body
= Fever, large joints, subcutaneous nodules, erythema marginatum, syndenham chorea and heart disease
What antibodies will be (+) with Rheumatic fever?
DNase B
Streptolysin B
Rheumatic Heart Disease affects which valves in order from most often to least often?
MAT
- Mitral
- Aortic
- Tricuspid
Findings of Acute Rheumatic Heart Disease?
- Peri/Myo/Endo (pan) - carditis
- Verrucae formation
- MacCallum Plaques
Findings of Chronic Rheumatic Heart Disease?
- Valvular leaflet thickening
- Valvular stenosis
Infective Endocarditis usually occurs where and is of what origin?
- BACTERIAL
- - usually occurs on abnormal or prosthetic heart valves
Acute Infective Endocarditis symptoms
Rapid fever, chills and weakness
What bacteria usually causes Acute Infective Endocarditis?
Staph. Aureus
With IV drug use, where will the infective endocarditis be and what bacteria?
Right sided
- Staph. Aureus
Subacute Infective Endocarditis Symptoms?
Low grade fever and fatigue
What bacteria may cause Subacute Infective Endocarditis especially on prosthetic heart valves?
Staph. Epidermidis
What bacteria may cause Subacute Infective Endocarditis, especially after dental procedures?
Strep. Viridans and HACEK group
What other manifestations can be seen with Infective Endocarditis? (4)
Subungual splinter hemorrhages
Janeway lesions
Osler nodes
Roth spots on eye
What other manifestations can be seen with Infective Endocarditis? (4)
Subungual splinter hemorrhages
Janeway lesions
Osler nodes
Roth spots on eye
What are 3 possible causes of NONbacterial Thrombotic Endocarditis?
Cancer
SLE
Antiphospholipid Syndrome
Symptoms of NONbacterial Thrombotic Endocarditis?
Asymptomatic –> Valvular thrombi
How does Carcinoid Heart Disease arise?
- Carcinoid tumors secrete serotonin
- Plaque-like endocardial and valve thickening
Symptoms and side of Carcinoid Heart Disease?
- RIGHT side
= Flushing, diarrhea and bronchospasm
Asymptomatic –> valvular thrombi
NONbacterial thrombotic endocarditis
Flushing, diarrhea and bronchospasm with the right side of the heart affected are seen with?
Carcinoid Heart Disease
