CVR - Structural Heart Disease

Question 1

What are the determinants for cardiac stroke volume?

Answer 1

• Energy contraction:
  
  • Starling’s law of the heart
  • Cardiac contractility
• Arterial pressure

Question 2

What is laplace’s law?

Answer 2

The internal pressure in a chamber is directly proportional to the wall tension and inversely proportional to the radius of the chamber

Question 3

Describe aortic stenosis

Answer 3

The aortic valve becomes significantly narrow, valvular area <1cm^2
severe if blood flow >4m/s

Question 4

What can cause aortic stenosis?

Answer 4

• Genetics
• Degeneration of valve with age
• Rheumatic hard disease
• Infective endocardititis
• Hyperuracaemaia

Question 5

Describe mitral stenosis?

Answer 5

Narrowing of the mitral valve

Question 6

What can cause mitral stenosis?

Answer 6

• Rheumatic fever
• Congenital
• Rheumatoid artheritis

Question 7

What is the effect of aortic stenosis on the afterload and resultantly the heart?

Answer 7

• Aortic stenosis increases afterload which means the heart has to work harder to pump blood
• This leads to thickening of the left ventricle abnormally, left ventricular hypertrophy

Question 8

What is the effect of mitral stenosis on the afterload and resultantly the heart?

Answer 8

• Increases pressure in atrium
• Dilates atrium
• Leads to irregular rhythms, i.e - atrial fibrillation

Question 9

What are regurgitation lesions?

Answer 9

When the valve dilates

Question 10

What are the causes of mitral regurgitation?

Answer 10

• Rheumatic fever
• Mitral valve prolapse
• Atrial dilation

Question 11

What is the issue with mitral regurgitation?

Answer 11

It reduces cardiac output through the aorta which reduces blood flow to the rest of the body
Can lead to heart failure

Question 12

What can cause aortic regurgiation?

Answer 12

• Bicuspid aortic valve
• Marfan syndrome
• Rheumatic fever
• Acute endocarditits

Question 13

What is the consequence of aortic regurgitation?

Answer 13

Blood flows back into the left ventricle which results in a greater volume in it which dilates it and makes it more inefficient

Question 14

What are the 3 classifications of cardiomyopathy?

Answer 14

• Hypertrophic
• Dilated
• Arrhythmogenic right ventricular

Question 15

What is cardiogenic shock?

Answer 15

Impairment of cardiac systolic function resulting in reduced cardiac output causing end organ dysfunction