Cardiovascular: Heart valves and malformations

Question 1

How many valves are there in a human heart?

Answer 1

4

Question 2

How many valves are on the right side of the heart?

Answer 2

2

Question 3

How many valves are on the left side of the heart?

Answer 3

2

Question 4

What are the valves on the right side called?

Answer 4

Pulmonary

Tricuspid

Question 5

What are the valves on the left side called?

Answer 5

Aortic

Mitral

Question 6

On what side of the heart does valve failure occur most commonly and was causes it?

Answer 6

Left side (aortic and mitral valves)

Stenosis

Question 7

What are valves?

Answer 7

Cusplets of collagen

Question 8

What muscles are responsible for the attachment of valves?

Answer 8

Papillary muscles

Question 9

What are the symptoms of heart valve disease?

Answer 9

Commonly no symptoms.

esp in patients with low levels of activity.

Question 10

What are the causes of valve disease?

Answer 10

Congenital/developmental defects:
i.e. bicuspid aortic valve (instead of tricuspid)

Rheumatic fever:
Immunological reaction to strep A that cross reacts with host proteins.

Myocardial infarction:
Leads to death of cardiac muscle which causes papillary muscles to rupture/tear which leads to valve failure as there are no papillary muscles to prevent them from inverting.

Aortic root dilation:
Caused by syphilis
Leads to aortic aneurysm.

Question 11

How is valve disease treated?

Answer 11

Valve replacement with a porcine/mechanical valve.

Question 12

With which valve replacement will the patient have to take anticoagulants?

Answer 12

Mechanical valve 
(not required for porcine)

Question 13

In what type of patients would a porcine valve be favoured?

Answer 13

Young and elderly

Question 14

Why would a porcine valve be the favoured option in a young patient?

Answer 14

If a patient receives a mechanical heart valved they have to take anticoagulants.

Children are prone to injury therefore having them on anticoagulants would increase their risk of bleeding out.

Porcine valves also have a shorter life span than mechanical valves - this characteristic is suited in a child valve replacement as their valve will have to be replaced again as they grow (heart will get larger).

Question 15

Why would a porcine valve be the favoured option in an elderly patient?

Answer 15

Elderly patient are also prone to injury - porcine valves do not require anticoagulants so there is less chance of the patient bleeding out.

Porcine valves have a short life span and an elderly patient also has a shorter life expectancy.

Question 16

What are the risks of valve replacement?

Answer 16

Endocarditis

Question 17

Describe the link between oral hygiene and endocarditis.

Answer 17

Bacteria that have a strong link to endocarditis are found within the oral cavity.

This bacteria can become systemic during procedures that irritate the gingival margin ie. toothbrushing or after an extraction etc.

This bacteria can travel through the bloodstream and target the replaced valve causing infection.

** Pristine oral hygiene must be maintained in a patient receiving a valve replacement **