Heart Valvular Disease

Question 1

What drains into the right atrium?

Answer 1

Inferior vena cava and superior vena cava

Question 2

What leaves the right ventricle?

Answer 2

Pulmonary artery

Question 3

What valves are on the right side of the heart?

Answer 3

Tricuspid between right atrium and ventricle

Pulmonary valve between right ventricle and pulmonary A

Question 4

What drains to the left atrium?

Answer 4

pulmonary vein

Question 5

What leaves the left ventricle?

Answer 5

aorta

Question 6

What valves are on the left side of the heart?

Answer 6

Mitral between left atrium and ventricle

Aortic valve between ventricle and aorta

Question 7

How many leaflets does the aortic valve have?

Answer 7

3

Question 8

How many leaflets does the mitral valve have?

Answer 8

2

Question 9

What vessels supply the heart?

Answer 9

Coronary arteries and blood diffuses over the heart because the arteries dont penetrate the heart muscle

Question 10

What are two types of heart disease?

Answer 10

Stenosis (narrowing)

Regurgitation ( leaky)

Question 11

What is stenosis?

Answer 11

Narrowing, stiffening, thickening, fusion or blockage of the valve.
The defective valve then interferes with the smooth passage of blood

Question 12

What is the most common place for stenosis?

Answer 12

Aortic valve

Question 13

What happens during aortic valve stenosis?

Answer 13

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

Question 14

What sound does aortic stenosis give?

Answer 14

High pitch murmour (mid/late systole)

Question 15

What symptoms may occur and why?

Answer 15

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

Question 16

What occurs due to the high pressure of blood in the aorta?

Answer 16

Increased systolic stress
Wall thickening
Concentric hypertrophy
Reduced diameter of vessel

Question 17

What causes aortic stenosis?

Answer 17

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

Question 18

What is mitral valve stenosis?

Answer 18

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

Question 19

What sounds does mitral stenosis give?

Answer 19

High pitch systolic murmour

Question 20

What occurs due to mitral stenosis?

Answer 20

There is less blood flow to the left ventricle- reduced CO

Right side of heart is overburdoned and fails

Question 21

What are the causes of mitral stenosis?

Answer 21

Rheumatic fever - fusion of valves or calcification and shortening of chordae tendonae
Heart defect

Question 22

When do symptoms from mitral valve stenosis occur?

Answer 22

40/50 yrs

Aggravated by exercise/ pregnancy

Question 23

What is the treatment for stenosis?

Answer 23

Non invasive dilation of stenosis

Surgical intervention - replace or repair

Question 24

What is aortic valve regurgitation?

Answer 24

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

Question 25

What symptoms occur with aortic regurgitation?

Answer 25

mild - severe
fatigue
SOB
oedema
arrythmias
angina
sweating
atrial fibrilation
fainting
weakness
pain with exercise and relieves with rest

Question 26

What are the causes of aortic regurgitation?

Answer 26

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

Question 27

What is mitral valve regurgitation?

Answer 27

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

Question 28

What happens to the mitral valve during regurgitation?

Answer 28

The leaflets buckle back into the left atrium when the ventricle contracts

Question 29

When is mitral regurgitation worse?

Answer 29

When the left ventricular cavity is smaller (dehydration or during standing)

Question 30

What are the causes of mitral valve regurgitation?

Answer 30

PRIMARY - occurs on its own

SECONDARY - link to another disease eg polycystic kidney

Question 31

What complications can occure with mitral valve regurgitation?

Answer 31

Stroke - lack of blood to brain
IE
Arrythmias
TIA

Question 32

What is the treatment for regurgitation?

Answer 32

Medication

Surgery - repair or replace with artificial, mechanical or biological valve

Question 33

What is IE?

Answer 33

Infective Endocarditis

An inflammation of the inner tissues of the heart, the endocardium (such as its valves)

Question 34

What causes IE?

Answer 34

third caused by staph
third caused by strep
20% die in initial hosp admission and 15% in 1 yr following

Question 35

What is the treatment for IE?

Answer 35

Prosthetic valve replacement - 45% require this

Question 36

What symptoms occur with IE?

Answer 36

fever, malaise, fatigue