Developmental Valve

Question 1

Types of Developmental Abnormalities in valves that might not be recognized in the neonatal / childhood period

Answer 1

1. Hypoplastic valve
2. Unicuspid aortic valve
3. Bicuspid aortic valve

Question 2

1. Hypoplastic valve
2. Unicuspid aortic valve
3. Bicuspid aortic valve
   Problems?

Answer 2

1. Reduced outflow, leading to ventricular hypertrophy

2. Increased turbulence, leading to valve thickening and stenosis

Question 3

Bicuspid Aortic Valve is relatively common, and is cause ______

Answer 3

when two of the aortic leaflets fuse

Question 4

Bicuspid Aortic Valve appearance (congenital)

Answer 4

thich

calcified

Question 5

Acquired Diseases of valves

Answer 5

Degenerative - “Toxic-Metabolic” / Developmental / Traumatic

1. Stenosis and/or
2. Regurgitation/Insufficiency

Question 6

The ________ valves are the predominant valves involved in Acquired Diseases of valves

Answer 6

aortic and mitral

higher pressure

Question 7

Acquired Diseases of valves- The abnormal valves show increased susceptibility to:

Answer 7

1. Nodular calcification and fibrosis
2. Vegetation formation
3. Infection

Question 8

Rheumatic heart disease tends to affects:

Answer 8

Mitral and Aortic valve

Question 9

Marfrans tend to have

Answer 9

dilated aortic root which can lead to regurg

Question 10

Mitral Valve Prolapse

Answer 10

• Ballooning
• Tenting
• Myxomatous degeneration
• Hooding
  (aka Myxomatous degeneration)

Question 11

Most common cause of isolated mitral regurgitation (occurs in ~5% of
the population)

Answer 11

MItral Prolapse

Question 12

Rheumatic Fever

Answer 12

Group A Streptococcus (Strep. pyogenes)

Antibodies against M protein cross rxn w/ glycoproteins

Question 13

Criteria for Diagnosis of Rheumatic Fever

Answer 13

Jones Criteria

J- joint
o- Sydenham chorea” CNS

Question 14

Chronic effects of myocardial damage

Answer 14

endocardium
myocardium
pericardium

Question 15

Rheumatic Fever affects ________ valves

Answer 15

mitral and aortic valves

Question 16

inflammation of endocardium / valves and eventual
fibrosis

Mitral Valve (65-75% of cases)
Aortic Valve w/ MV (25% of cases)

Answer 16

Endocarditis (RF)

Question 17

Endocarditis Rheumatic Heart Disease Complications:

Answer 17

Valves can’t open (stenosis) or close (regurgitation)
normally … can progress to heart failure
- Susceptibility to infective endocarditis

Question 18

Rheumatic changes of Mitral Valve

Answer 18

a. Valve Leaflets and Cusps: fibrosis, fusion, calcification

b. Chordae Tendinea: fibrosis, fusion, and shortening

Question 19

Acquired Diseases: Vegetations of Valve

Answer 19

Sterile / Marantic / Non-Bacterial Thrombotic
Endocarditis

Infective Endocarditis

Question 20

Primary infection of normal valve or damaged valve

Answer 20

Infective Endocarditis

Blood culture key in attempt to identify causative organism (the organism is not identified in some cases)

Question 21

Normal Valves are more commonly infected by:

Answer 21

virulent organisms

i.e., Staph aureus

Question 22

Risk/Cause for Endocarditis

Answer 22

• Dental procedures
• Surgical procedures
• Venous access for IV drug abuse

-

Question 23

Highly virulent organisms (Staph aureus), which can destroy the valve leaflets resulting in :

Answer 23

perforation and incompetence with acute onset congestive heart failure
- Can infect normal and abnormal valves

Question 24

Endocarditis often leads to

Answer 24

emboli (septic or blood clot)

Question 25

Do vegetations require an organism?

Answer 25

No