Heart Valvular Disease Flashcards
What drains into the right atrium?
Inferior vena cava and superior vena cava
What leaves the right ventricle?
Pulmonary artery
What valves are on the right side of the heart?
Tricuspid between right atrium and ventricle
Pulmonary valve between right ventricle and pulmonary A
What drains to the left atrium?
pulmonary vein
What leaves the left ventricle?
aorta
What valves are on the left side of the heart?
Mitral between left atrium and ventricle
Aortic valve between ventricle and aorta
How many leaflets does the aortic valve have?
3
How many leaflets does the mitral valve have?
2
What vessels supply the heart?
Coronary arteries and blood diffuses over the heart because the arteries dont penetrate the heart muscle
What are two types of heart disease?
Stenosis (narrowing)
Regurgitation ( leaky)
What is stenosis?
Narrowing, stiffening, thickening, fusion or blockage of the valve.
The defective valve then interferes with the smooth passage of blood
What is the most common place for stenosis?
Aortic valve
What happens during aortic valve stenosis?
The valve doesn’t open well but the left ventricle still needs to pump blood through it so the ventricle uses more force to pump through narrower aortic valve.
This means that the blood gets past this valve using elongated bursts of less blood volume, and results in the blood in the aorta having a higher pressure
What sound does aortic stenosis give?
High pitch murmour (mid/late systole)
What symptoms may occur and why?
Dizzy as less blood getting to brain SOB on exercise Palpitations Irregular rhythm Fainting Chest pain due to increased demand of 02 by left ventricle
What occurs due to the high pressure of blood in the aorta?
Increased systolic stress
Wall thickening
Concentric hypertrophy
Reduced diameter of vessel
What causes aortic stenosis?
Congenital heart disease - aortic valve doesnt have 3 leaflets and so doesnt open as wide as it should
Build up of calcium - often in elderly
Rheumatic fever
What is mitral valve stenosis?
Narrowing of the mitral valve.
Left atrium must increase the pressure to push blood into the ventricle.
This increase blood pressure backs up to the lungs and further to the right side of the heart which means that fluid pools in the organs and they will swell
What sounds does mitral stenosis give?
High pitch systolic murmour
What occurs due to mitral stenosis?
There is less blood flow to the left ventricle- reduced CO
Right side of heart is overburdoned and fails
What are the causes of mitral stenosis?
Rheumatic fever - fusion of valves or calcification and shortening of chordae tendonae
Heart defect
When do symptoms from mitral valve stenosis occur?
40/50 yrs
Aggravated by exercise/ pregnancy
What is the treatment for stenosis?
Non invasive dilation of stenosis
Surgical intervention - replace or repair
What is aortic valve regurgitation?
Blood from the left atrium to the left ventricle but then due to the leaky aortic valve, blood doesnt go into the aorta because it leaks back to the ventricle.
The left ventricle increase in volume and distends so that it cant squeeze itself
What symptoms occur with aortic regurgitation?
mild - severe fatigue SOB oedema arrythmias angina sweating atrial fibrilation fainting weakness pain with exercise and relieves with rest
What are the causes of aortic regurgitation?
Dilatation of the aortic root due to tissue abnormality (most common cause) Congenital - valve has 2 cusps not 3 Hypertension IE Rheumatoid arthritis Syphilis Lupus
What is mitral valve regurgitation?
Blood moves from left atrium to the left ventricle but when the left ventricle contracts, the blood rushes back to the atrium. (The mitral valve should be closed)
This means that less blood is pushed into the aorta from the left ventricle and so the is less blood in circulation around the body
What happens to the mitral valve during regurgitation?
The leaflets buckle back into the left atrium when the ventricle contracts
When is mitral regurgitation worse?
When the left ventricular cavity is smaller (dehydration or during standing)
What are the causes of mitral valve regurgitation?
PRIMARY - occurs on its own
SECONDARY - link to another disease eg polycystic kidney
What complications can occure with mitral valve regurgitation?
Stroke - lack of blood to brain
IE
Arrythmias
TIA
What is the treatment for regurgitation?
Medication
Surgery - repair or replace with artificial, mechanical or biological valve
What is IE?
Infective Endocarditis
An inflammation of the inner tissues of the heart, the endocardium (such as its valves)
What causes IE?
third caused by staph
third caused by strep
20% die in initial hosp admission and 15% in 1 yr following
What is the treatment for IE?
Prosthetic valve replacement - 45% require this
What symptoms occur with IE?
fever, malaise, fatigue
