Developmental Valve Flashcards
Types of Developmental Abnormalities in valves that might not be recognized in the neonatal / childhood period
- Hypoplastic valve
- Unicuspid aortic valve
- Bicuspid aortic valve
- Hypoplastic valve
- Unicuspid aortic valve
- Bicuspid aortic valve
Problems?
- Reduced outflow, leading to ventricular hypertrophy
2. Increased turbulence, leading to valve thickening and stenosis
Bicuspid Aortic Valve is relatively common, and is cause ______
when two of the aortic leaflets fuse
Bicuspid Aortic Valve appearance (congenital)
thich
calcified
Acquired Diseases of valves
Degenerative - “Toxic-Metabolic” / Developmental / Traumatic
- Stenosis and/or
- Regurgitation/Insufficiency
The ________ valves are the predominant valves involved in Acquired Diseases of valves
aortic and mitral
higher pressure
Acquired Diseases of valves- The abnormal valves show increased susceptibility to:
- Nodular calcification and fibrosis
- Vegetation formation
- Infection
Rheumatic heart disease tends to affects:
Mitral and Aortic valve
Marfrans tend to have
dilated aortic root which can lead to regurg
Mitral Valve Prolapse
- Ballooning
- Tenting
- Myxomatous degeneration
- Hooding
(aka Myxomatous degeneration)
Most common cause of isolated mitral regurgitation (occurs in ~5% of
the population)
MItral Prolapse
Rheumatic Fever
Group A Streptococcus (Strep. pyogenes)
Antibodies against M protein cross rxn w/ glycoproteins
Criteria for Diagnosis of Rheumatic Fever
Jones Criteria
J- joint
o- Sydenham chorea” CNS
Chronic effects of myocardial damage
endocardium
myocardium
pericardium
Rheumatic Fever affects ________ valves
mitral and aortic valves
inflammation of endocardium / valves and eventual
fibrosis
Mitral Valve (65-75% of cases) Aortic Valve w/ MV (25% of cases)
Endocarditis (RF)
Endocarditis Rheumatic Heart Disease Complications:
Valves can’t open (stenosis) or close (regurgitation)
normally … can progress to heart failure
- Susceptibility to infective endocarditis
Rheumatic changes of Mitral Valve
a. Valve Leaflets and Cusps: fibrosis, fusion, calcification
b. Chordae Tendinea: fibrosis, fusion, and shortening
Acquired Diseases: Vegetations of Valve
Sterile / Marantic / Non-Bacterial Thrombotic
Endocarditis
Infective Endocarditis
Primary infection of normal valve or damaged valve
Infective Endocarditis
Blood culture key in attempt to identify causative organism (the organism is not identified in some cases)
Normal Valves are more commonly infected by:
virulent organisms
i.e., Staph aureus
Risk/Cause for Endocarditis
- Dental procedures
- Surgical procedures
- Venous access for IV drug abuse
-
Highly virulent organisms (Staph aureus), which can destroy the valve leaflets resulting in :
perforation and incompetence with acute onset congestive heart failure
- Can infect normal and abnormal valves
Endocarditis often leads to
emboli (septic or blood clot)
Do vegetations require an organism?
No
