CSIM1.62 CDVS D/z 2

Question 1

Main causes of valvular heart diseases

Answer 1

Rheumatic valve disease
Calcified aortic stenosis
Valve ring dilatation and leaflet degeneration
Infective endocarditis
Congenital heart disease

Question 2

Define stenosis and insufficiency of valves

Answer 2

Stenosis = cannot fully open (impaired forward flow)
Insufficiency = cannot fully close (regurg)

Question 3

What kind of disease is the mitral valve prone to?

Answer 3

Prolapse, stenosis or barlow’s disease

Question 4

What is barlow’s disease of the mitral valve?

Answer 4

Thickened, enlarged valve with excess leaflet tissue

Question 5

What are some clinical features of cardiac valve disease

Answer 5

Murmur, heart failure, atrial fibrillation, syncope, endocarditis risk

Question 6

What are some causes of mitral stenosis

Answer 6

Rheumatic heart disease

Question 7

What are some causes of mitral regurgitation

Answer 7

Infective endocarditis
Mitral valve prolapse
Papillary muscle/chordae tendinae rupture

Question 8

What are some causes of aortic valve stenosis

Answer 8

Rheumatic heart isease
Senile calcific aortic stenosis
Congenital bicuspid aortic valve

Question 9

What are some causes of aortic valve regurgitation

Answer 9

Rheumatic heart disease
Infective endocarditis
Connective tissue disorders
Dilatation of aortic root
Marfan's syndrome

Question 10

What is rheumatic fever?

Answer 10

It occurs about 2 weeks after a group A streptococcus infection

In which antibodies against the pathogen are able to recognise valvular tissue as well, causing a cross reaction.

This causes damage and vegetative formation on the valves leading to damage and malfunction.

Question 11

Symptoms of rheumatic fever?

Answer 11

Sydenham’s chorea, carditis, erythema marginatum of skin, migratory polyarthritis of large joints and others.

Question 12

What does “fish mouth valve” refer to?

Answer 12

Mitral stenosis caused by fibrosis of mitral valve.

Question 13

Describe calcific aortic stenosis

Answer 13

Formation of calcific masses on aortic side of cusps. Disrupts full opening of aortic valve during systole.

Question 14

What is the best treatment for mitral degeneration?

Answer 14

Valve reconstruction

Question 15

Common cause for infective endocarditis

Answer 15

Oral/pyogenic streptococcus and staph aureus

Next most common is group D streptococcus and enterococci

Question 16

What do valve vegetations contain?

Answer 16

Fibrin, inflammatory cells, granulation tissue and microorganisms

Question 17

Clinical features of infective endocarditis?

Answer 17

Fever, chills, fatigue, weight loss.
Immune mediated glomerulanephritis
Murmurs,

septic embolism in peripheral organs.

microemboli symptoms include subungal splinter haemorrhage, janeway lesions, osler’s nodes and retinal haemorrhages