Cardiac Structural Abnormalities And Disorders

Question 1

Mitral valve prolapse

Answer 1

Can cause physical abnormalities such as autonomic dysfunction.
Can occur with dyspnea, syncope, dizziness, and arrhythmia. No relationship btw degree of valve degeneration and severity of symptoms.
When prolapse progresses to causing regurgitation the LA stretches and remodelling of the myocardium occurs - can be responsible for PVC’s SVE’s(Afib/flutter)
MVP -> mitral insufficiency -> bi-atrial enlargement, LVH -> CHF, weakness, dyspnea, dizziness and effort intolerance.

Question 2

ECG changes with mitral disease

Answer 2

Bifasicular block
A fib -> increases with aging and compounded by LAE. Less commonly A flutter
LAE result in notched p waves, LVH changes include tall R’s in precordial and non-specific St-T changes

Question 3

Risk factors contributing to the development of aortic stenosis (AS)

Answer 3

Increasing age
Hypertension
Smoking
Elevated LDL Cholesterol
Elevated lipoprotein A

Question 4

Aortic stenosis

Answer 4

Prevalent in aging population, more common in men. Associate with mortality rate of 50% after 2 years when left untreated
Causes decrease in blood flow through the aorta.
Strain across valve increases back pressure in LV -> thickened wall
Strain on ventricle weakens pumping action.

Question 5

What does it take to diagnose aortic stenosis

Answer 5

Echocardiography
Chest x-ray
Cardiac catheterization
ECG

Question 6

Common ECG changes for AS

Answer 6

LBBB
Bifascicular block
LVH with strain
Degrees of ischemia

Question 7

Endocarditis

Answer 7

Major cause of valvulpathy
Most common systemic infections assoc is rheumatic fever
Systemic infection -> valvular vegetation -> epithelial and fibrin tendrils form clumps of tissue to underlying structure -> turbulent blood flow over valve -> form emboli ->valve leaflets can develop adhesions

Question 8

Treatment of endocarditis

Answer 8

Valves have no direct blood supply so treating is difficult. Chordate tendons with shorten and thicken, valves with thicken and commisures fuse. Damage will remain after resolution of infection. Vegetations are the only changes that can be reversed