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Patho Summer Test #1 > Cardiovascular Module #6 > Flashcards

Cardiovascular Module #6 Flashcards

1
Q

What are the 2 types of valvular dysfnction?

A

Stenotic

Insufficiency

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2
Q

Which side of the of heart is it more common to have valve disorders?

A

Left Side

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3
Q

What happens in stenotic conditions?

A

Narrowing of the orifice of the valve which restricts blood flow throught

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4
Q

What are the causes of aortic valve (left semilunar) sentosis?

A

Congenital = abnromal formation of the valve (have bicuspid valve instead of normal tricuspid valve)

Degenerative Changes

Inflammatory secondary to rheumatic heart disease

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5
Q

What are the primary mechanical effects on the cardiac pump?

A

Reduced outflow of left ventricle = incomplete empyting of L ventricle/increased end-systolic LV pressure

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6
Q

What are the secondary mechanical effects on the cardiac pump?

A

Hypertrophy of L ventricle as compensation to increased workload

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7
Q

What are the output changes seen in aortic valve stenosis?

A

↓SV/↓CO

↓systolic BP

↓pulse pressure

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8
Q

What are the cardiac pressure/congestion changes seen in aortic valve stenosis?

A

↑ left atrial pressure (↑ PCWP)

pulmonary HTN

↑ pulmonary pressures –> edema

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9
Q

What are the symptoms of aortic valve stenosis?

A

Dyspnea on exertion (DOE)

Syncope

Angina Symptoms

Can progress to heart failure

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10
Q

When would you hear the heart murmur w/ aortic valve stenosis?

A

Systolic

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11
Q

What is the cause of mitral (L AV valve) stenosis?

A

Rheumatic Heart Disease

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12
Q

What are the primary mechanic effects on the cardiac pump seen in mitral stenosis?

A

Reduced outflow of L atria = incomplete emptying of L atria/increased LA pressures

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13
Q

What are the secondary mechanical effects on the cadiac pump seen in mitral stenosis?

A

L atria dilation d/t incomplete emptying of L atria

Hypertrophy as compensation to increased workload

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14
Q

What are the output changes seen w/ mitral stenosis?

A

Potential exertional insufficiency of ↓SV/↓CO

**heart is able to compensate during rest, but you see defect during exercise when you would need to pump faster

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15
Q

What are the cardiac pressure/congestion changes you see w/ mitral stenosis?

A

↑ left atrial pressure (↑ PCWP)

pulmonary HTN

↑ pulmonary pressures –> edema, right ventricular congestion/failure

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16
Q

What kind of symptoms do you see w/ mitral stenosis?

A

Prominent pulmonary symptoms/complications d/t pulmonary HTN/edema:

   Dyspnea on Exertion

   Orthopnea (difficult breathing laying 
   down/easier sitting up)

   Nocturnal Dyspnea

Non-angina type chest discomfort (atypical chest pain)

17
Q

When do you hear the heart murmur w/ mitral stenosis?

A

Diastolic

**narrowed AV valve during ventricular filling

18
Q

Generally what is the problem in regurgitation conditions?

A

Insufficiency or incompetence

Inability of valve to completely close allows back-flow of blood

19
Q

What are the primary mechanical effects on the cardiac pump in aortic valve insufficiency/incompetence?

A

During ventricular relaxation (diastole) blood from aorta “back-flows” into L ventricle –> increased end-diastolic filling volumes of L ventricle

20
Q

What are the primary output changes seen in aortic valve insufficiency/incompetence?

A

↑ SV/CO to accommodate for “back-flow loss”

21
Q

What are the primary pressure changes seen in aortic valve insufficiency/incompetence?

A

“spread out”↑ systolic BP

↓ diastolic BP

↑ pulse pressure

22
Q

What are the secondary mechanic effects seen in aortic valve insufficiency/incompetence?

A

L Ventricle Dilation (to compensate/maintain SV/CO volumes)

L Ventricle Hypertrophy (to compensate for increased workload w/ larger SV/CO)

23
Q

What are the secondary cardiac pressure/congestion changes?

A

↑ pulmonary pressure and edema

24
Q

Clinically what are the symptoms seen with aortic valve insufficiency/incompetence?

A

Angina type discomfort

Dyspnea on Exertion

Bounding peripheral pulses (d/t pulse pressure changes)

25
Q

When do you hear the murmur associated w/ aortic valve insufficiency/incompetence?

A

Diastolic

26
Q

What are the primary mechanical effects on the cardiac pump in mitral insufficiency/incompetence?

A

Back flow of blood into L atria during ventricular contraction (systole)…leads to:
increased L atrial volumes/pressures

     left atrial dilation/hypertrophy

     viscous cycle as atrial dilation may 
     enlarge mitral valve even more

Eventually compensation fails to maintain CO and heart failure occurs

27
Q

When do you hear the murmur in mitral valve insufficiency/incompetence?

A

Systolic

28
Q

What is the most common valve disorder in the US?

A

Mitral Valve Prolapse Syndrome

29
Q

What happens in mitral valve prolapse syndrome?

A

Enlarged cusps of mitral valve prolapse back (billow back) into L atrium during systole

May develop mitral valve regurgitation

30
Q

What are the symptoms of mitral valve prolapse syndrome?

A

Have large continuum of presentation/prognosis –> no symptoms - symptoms (most have good prognosis w/o symptoms/complications)

Might hear mid-systolic click or systolic murmur

31
Q

What causes tricuspid (R AV valve) insufficiency/incompetence?

A

Congenital

Secondary to pulmonary HTN pathologies

32
Q

What are the mechanical effects on the cardiac pump in tricuspid insufficiency/incompetence?

A

Pulmonary HTN/congenital regurgitation causes back flow into R atria, leads to:

            increased R atrial pressures --> 
            increased venous pressures 
            (increased CVP)

            increased atrial volumes/pressures 
            --> R ventricular volumes/pressures

            R ventricular hypertrophy/dilation to 
            compensate/maintain CO
33
Q

What are some of the symptoms seen w/ tricuspid (R AV) insufficiency/incompetence?

A

Distended Jugular Veins

Lower extremity/generalized edema

34
Q

When do you hear the heart murmur w/ tricuspid (R AV) insufficiency/incompetence?

A

Systolic

Patho Summer Test #1 (8 decks)

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