Chapter 11: Valvular Heart Disease Flashcards
A febrile illness with widespread connective tissue acute
inflammation but especially heart and joints
Rheumatic fever (RF)
True or false: Rheumatic fever is a hypersensitivity reaction.
True
What causes rheumatic heart disease (RHD) a complication of? What does it result in?
Scarring of heart valves by rheumatic fever
True or false: Rheumatic fever is a bacterial infection.
False; it is an immunologic complication following infection by group A beta hemolytic Streptococcus
How do you prevent Rheumatic fever?
Treat beta-Strep promptly.
How do you prevent Rheumatic heart disease in folks who have had RF before?
Provide prophylactic penicillin throughout childhood and young adulthood to prevent additional strep infections , recurrent RF, and further valve damage.
What type of valvular disease may occur as a
result of a congenital bicuspid aortic valve
abnormality or calcific aortic stenosis?
Nonrheumatic Aortic Stenosis
In what two ways can Nonrheumatic Aortic Stenosis occur?
1) Congenital bicuspid aortic valve abnormality
2) Calcific aortic stenosis
Which part of the heart is strained by calcific aortic stenosis?
Left ventricle
What is the treatment for calcific aortic stenosis?
prosthetic valve replasement
What is the top cause of valve replacement in the US and Europe?
Calcific aortic stenosis
True or false: the same risk factors that predispose a person to CAD also predispose a person to CAS (cardiac aortic stenosis).
True
How is mitral valve prolapse diagnosed?
echocardiogram
How is mitral valve prolapse treated?
Treat prophylactically with ABX prior to dental/surgical procedures; Valve repair or replacement if severe.
What are the two major types of prosthetic heart valves?
1) Mechanical
2) Bioprosthetic
What does an artificial heart valve increase the risk of?
Infective endocarditis
What is the downfall of mechanical valve replacements?
Increased risk of blood clots
On valves of which side of the heart is infective endocarditis usually seen?
Left side
True or false: Subacute infective endocarditis is usually caused by highly virulent organisms.
False; low virulence
Why do people with heart valve damage or artificial valves go on prophylactic antibiotic prior to dental or surgical procedures?
To prevent subacute infective endocarditis
Which valve in the heart is most often infected by acute infective endocarditis?
R tricuspid valve (because this is soon after blood enters heart)
True or false: Acute valve infections tend to affect valves on the L side of the heart.
False; right side
What type of condition is rheumatic fever?
Acute autoimmune hypersensitivity
How can rheumatic heart disease occur?
1) Strep infection
2) A couple of weeks later, rheumatic fever (body creates Abs against strep that attack joints and heart valve–especially the mitral valve).
3) This usually resolves with some scarring
4) Repeated scarring from additional strep infections leads to RHD
What are the possible outcomes of RHD?
1) Stiff valves cause heart to work harder
2) Blood backs up to congest lungs
What are the two main types of nonrheumatic aortic stenosis?
1) Congenital bicuspid valve (born with tricuspid valve containing 2 instead of 3 cusps)
2) Calciforic aortic stenosis
What are the 5 main conditions affecting heart valves?
1) Rheumatic heart disease
2) Non-rheumatic heart disease
3) Mitral valve prolapse
4) Artificial valves
5) Infective endocarditis
What is the prognosis for someone with calcific aortic stenosis with no valve replacement?
less than 5 years
True or false: Infective endocarditis is common, but usually not serious.
False; it is rare, but usually serious.
True or false: Patients with artificial heart valves are less vulnerable to endocarditis.
False; more vulnerable
_______________ endocarditis is caused by low levels of low virulence bacteria.
Subacute
_______________ endocarditis is caused by highly virulent bacteria (often staph).
Acute
Which valve is usually affected by acute endocarditis?
R AV valve (tricuspid); because it is the first encountered in blood flow through the heart
