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Heart Valve Disease > Heart Valve Disease > Flashcards

Heart Valve Disease Flashcards

1
Q

Coaptation

A

When the heart valves come together.

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2
Q

Aortic valves ———– as you get older.

A

thicken. AKA fibrosis.

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3
Q

3 types of valvular heart disease.

A

1) Rheumatic Heart Disease
2) Infective Endocarditis
3) Non-infective Endocarditis

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4
Q

Saying about Rheumatic Fever

A

“RF licks the joints but bites the heart.”

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5
Q

How do you get RF (organism)?

A

You get infected with a beta-hemolytic (GAS) strep bacteria.

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6
Q

What are on the surface of the GAS strep bacteria?

A

An M protein and streptolysin (an exotoxin).

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7
Q

Why is the heart attacked in Rheumatic Fever?

A

Because the myosin and tropomyosin of the heart share the same M proteins as those found on the strep bacterial surface.

So the body’s antibodies attack the strep bacteria and also the heart muscle.

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8
Q

How does acute Rheumatic fever first present?

A

Pharyngitis then inflammation of the joints.

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9
Q

Clinical diagnosis of Rheumatic Heart Disease.

A

Jones criteria:

1) Rheumatic component.
2) Heart disease.
3) Recent GAS infection.
4) Polyarthritis
5) Skin lesions

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10
Q

Antibodies to the M protein on the strep bacteria ———— with M proteins on myosin and tropomyosin.

A

cross-react

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11
Q

Skin lesion associated with Rheumatic Fever/Heart Disease.

A

Erythema Marginatum

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12
Q

3 changes in the heart from Rheumatic heart disease.

A

(1) Vegetations
(2) Myocardial Aschoff bodies
(3) Fibrinous pericarditis

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13
Q

The look of the pericardium in rheumatic pericarditis.

A

Bread and butter appearance.

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14
Q

Aschoff Body

A

1) In acute Rheumatoid Fever.
2) Only in the heart.
3) Granuloma-like lesion.
4) Macrophages are present - called Anitschkow myocytes.

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15
Q

Caterpillar cell

A

AKA Anitschkow myocyte seen in Aschoff bodies.

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16
Q

Most important aspect of Acute Rheumatic Fever

A

Valvulitis.

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17
Q

Order of valves most to least affected

A

Mitral valve -> Aorta -> Tricuspid -> Pulmonary valves

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18
Q

Valvulitis of ARF

A

Verrucae (wart-like vegetations) seen on the valves.

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19
Q

Chronic rheumatic Valve Disease

A

Occurs years after having acute Rheumatic Fever. You get a deformed, thickened, fibrotic valve.

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20
Q

Signature lesion of Rheumatic Fever

A

Mitral stenosis

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21
Q

Difference between acute and subacute bacterial endocarditis.

A

In Acute, the valve was normal to begin with and gets damaged. In Subacute, the valve was already damaged, but can get damaged more.

22
Q

Two types of bacterial endocarditis.

A

Acute and Subacute.

23
Q

Who gets fungal endocarditis?

A

Drug users or immunocompromised hosts.

24
Q

The organism that causes acute endocarditis.

A

Staph aureus.

25
Q

The organism that causes subacute endocarditis.

A

Staph viridans.

26
Q

What causes endocarditis?

A

Blood that is contaminated with bacteria gets to the heart and infects the valves, then the infected valves shed the bacteria to the body.

27
Q

Sources of infection for endocarditis.

A

IV lines
Injection drug use
Dental procedures

28
Q

Pathogenesis of endocarditis.

A

1) The endothelium is damaged.
2) Matrix and collagen is exposed.
3) Causes platelet aggregation and fibrin deposits on the valve.

29
Q

Types of non-rheumatoid endocarditis

A

1) Infective

2) Non-Infective

30
Q

Types of Infective endocarditis.

A

1) Acute

2) Sub-acute

31
Q

Type of Non-infective endocarditis

A

1) Non-bacterial thrombotic endocarditis (marantic)

2) Atypical Verrucous endocarditis

32
Q

Non-Bacterial Thrombotic Endocarditis (NBTE)

A

1) Often occurs in a hypercoagulable state.
2) Associated with malignant disease.
3) Often affects a normal valve.
4) Often spares (doesn’t damage) the valve.
5) Gives rise to emboli.

33
Q

Marantic endocarditis AKA

A

NBTE

34
Q

What doesn’t NBTE have?

A

NO INFLAMMATION OR BACTERIA. They’re STERILE deposits.

35
Q

Vegetations are —— in NBTE.

A

Friable.

36
Q

Most common need for valve replacement.

A

Aortic Stenosis.

37
Q

Causes of aortic stenosis.

A

1) Rheumatic Fever

2) Aging

38
Q

Aortic stenosis causes —– ——– hypertrophy.

A

left ventricular

39
Q

_____ ______ is normal in aortic stenosis.

A

Serum calcium

40
Q

Risk factor for arterial stenosis.

A

High LDL, males, smoking.

41
Q

______ is related to stasis or endocardial injury.

A

Thrombosis.

42
Q

Most common heart tumor in adults.

A

Cardiac myxoma.

43
Q

Most common location of the cardiac myxoma.

A

Left atrium.

44
Q

Cardiac myxomas can ________.

A

embolize

45
Q

You’re not going to see these organisms in NBTE.

A

Neutrophils - because there’s no inflammation.

46
Q

Blood culture in NBTE.

A

NEGATIVE BC THERE ARE NO BACTERIA!!!!!

47
Q

Clinical features of infective endocarditis.

A 
Fever
Heart murmur
\+ blood culture
Known source of infection
Evidence of emboli
48
Q

Staph aureus causes.

A

Acute infective endocarditis. Affects normal valves.

49
Q

Staph viridens causes.

A

Subacute infective endocarditis. Affects already-damaged valves.

50
Q

Presentations of bacterial endocarditis.

A

Osler nodes
Janeway lesions
Splinter hemorrhages
conjunctival petechiae

51
Q

Patients who are septic and have severe burns can become _________, thus making them predisposed to ________.

A

Hypercoagulable; NBTE

Heart Valve Disease (1 decks)

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