CARDIOLOGY - Valvular Heart Disease and Bacterial Endocarditis Flashcards
Short term consequence of valvular inflammation
Collagen exposure
Thrombus development
Long term consequence of valvular inflammation
Post inflamm scarring
Which side valves are more commonly affected?
L
What is the most common cause of valve scarring
rheumatic fever
children who get rheumatic fever? clinical picture
inv tonsilitis/pharyngitis caused by GAS
ab GAS cross reacts cardiac antigen –> SL myocarditis/pericarditis
–> progressive fibrosis of valve leaflets + chordae tendinae
What is aortic stenosis is most commonly due to?
Calcification of congenital bicuspid aortic valve
Congenital cause pulmonary stenosis
Fallot’s tetralogy
Congenital cause mitral stenosis
Lutembacher’s syndrome
Congenital causes Tricuspid regurg
Ebstein’s anomaly
Ischaemic cause mitral regurg
Papillary mm dysfunction post infarction
Conditions causing cardiac remodelling (5)
SLE Marfans Ehler-Danlos Syphillis Ankylosing spondylitis
In what position is a patient postitioned to best hear a mitral valve murmur?
LHS
pathophysiology mitral stenosis
LA can’t empty –> pulmonary HTN
LA becomes hypertrophied+ dilated
Pulm HTN –> RHF
AF develops b/c mm hypertrophy
Sx Mitral stenosis (5)
Dyspnoea Haemoptysis Fatigue/weakness Abdo/L limb oedema Palps
Signs Mitral stenosis (5)
Malar flush Small vol pulse JV distension L parasternal heave Rumbling mid-diastolic murmur (just prior to systole)
Tx Mitral stenosis
AF (rate control + anti-coags)
Diuretics
Surgery if these measures fail
Surgical Mx mitral stenosis
Balloon valvuloplasty (if valve pliable)
Or
Open valvotomy
Causes mitral regurg
Rheumatic scarring
Post infarction papillary mm dysfunction
LV dilation
Mitral prolapse
Sx mitral regurg
Palps
dyspnoea/orthopnoea
Fatigue
Features RHF/CCF
Signs mitral regurg
lat apex beat w/ systolic thrill
Pansystolic murmur
AF?
Tx mitral regurg
Tx AF
Tx HF
Surgery if Sx deteriorate
In what position are aortic murmurs best heard
With patient sitting forward
Breath held on expiration
Causes aortic stenosis
Calcification
RF
Senile calcific degeneration
Prognosis aortic stenosis
2-3yrs - death