Know It Pt.6 Flashcards
MVP is ____ movement of one or both MV leaflets into the ____
Systolic ; LA
MVP is sometimes linked to ____ ____ disorders such as ________ and may be progressive
Connective tissue; Marfans syndrome
MVP is more common in young ___
Women (5-10%)
The congenital connective tissue disease that causes aortic dilation and Mitral valve prolapse is called?
Marfans syndrome
In Marfans syndrome why does aortic dissections and MVP occur?
A) increased systolic BP
B) aortic arteritis
C) lack of fibrilin
D) lack of collagen
C
MVP can also be caused by ______ ______
Myxomatous Degeneration
___% of people that have MVP will have ____
23% ; Tricuspid valve prolapse
What 5 diseases is MVP associated with?
Marfans syndrome
Secundum ASD
WPW
Lupus
Ehelers-Danlos
What is WPW?
Wolf Parkinson white syndrome is a congenital heart disorder. It’s a syndrome where people have extra pathways for electrical signals to travel between the heart.
This causes a fast heart beat of over 100
What is Lupus ?
Lupus is a autoimmune disorder that causes chronic inflammation by attacking your bodies own tissues and organs and body systems
What is Ehlers-Danlos?
Ehlers-Danlos syndrome is a group of inherited disorders that affect your connective tissues — primarily your skin, joints and blood vessel walls.
What is vascular Ehlers-Danlos ?
A syndrome that can cause the walls of your blood vessels, intestines or uterus to rupture.
What does Gracile Habitus means?
Thin for their tall height
What are some symptoms /signs of people that have Marfans syndrome?
-Garcia’s habitus (thin for their height)
- joint hyper flexibility
- optic lens dislocation
-high arched palate
With pt. That have Eheler Danlos what things should look for on the echo?
MVP
Ao dissection
So dilation
Severe Aortjc aneurysms are greater than?
A) 4.0cm
B) 4.5cm
C)5.0cm
D)7.0cm
C
What are the 2 standards for classifying dissections?
DeBakey scale
Stanford scale
The Stanford scale for aortic dissections has what classifications? Describe then
TYPE A - involves proximal aorta to left subclavian
TYPE B - involves aorta distal to left Subclavian (descending)
The DeBakey scale for aortic dissections has what classifications? Describe then
Type 1- Involves ascending & descending dissections
Type 2- Only involves ascending dissection
Type 3- Only involves descending dissection
A good way to remember the Stanford dissecfion scale va. The DeBakey is that the Stanford scale has ___ & ____ like the grades you want to get at the school!
A’s & B’s
What’s type 2 of the DeBakey scale?
Only ascending dissections
What’s type 3 of the DeBakey scale?
Only the descending dissection
What’s type B of the Stanford scale?
Distal to the left subclavian dissections
___% of people have Type 1 of the Bebakey scale.
60% ; type 1 of DeBakey scale is both ascending & descending
___% of people have Type 3 of the Bebakey scale
30%; Type 3 of the debakey scale is descending dissection only
MVP may cause ___ first which can then cause ______
MR; LAE
Patients with MVP are usually ____
Asymptomatic
What’s the murmur associated with MVP?
Mid systolic murmur / with or without click
People with MVP usually have a physical sign of _____ abnormalities
Skeletal
M-mode of MVP will show?
A) thickened leaflets with mid-late holodiastolic posterior movement. Displacement 2-3mm from C-D points
B) thickened leaflets with mid-late Holosystolic anterior movement. Displacement 2-3mm from C-D points
C) thickened leaflets with mid-late Holosystolic posterior movement. Displacement 2-3mm from C-D points
D) thickened leaflets with mid-late holodiastolic posterior movement. Displacement 2-3mm from D-E points
C
What two times/views should you never diagnose mitral valve prolapse?
- AP4
-In the presence of a large pericardial effusion
The ___ maneuver or _______ drug may provoke MVP
Valsalva ; amyl nitrate
Which of the following would increase or provoke mitral valve prolapse?
A) beta blocker
B) valsalva
C) calcium channel blocker
D)Atropine
B
The regurgitation jet direction with MVP will go in what direction if it’s the posterior leaflet prolapsing?
If the PMVL is prolapsed the regur jet will go anteriorly.
The regurgitation jet direction with MVP will go in what direction if it’s the anterior leaflet prolapsing
If the AMVL is prolapsing the regurgitation jet will go posteriorly
If a patient has a large pericardial effusion you may falsely notice a ?
Pseudo MVP
What is endocarditis?
Microorganisms that enter the bloodstream that attack and grow on valve tissue
What is endocarditis?
Microorganisms that enter the bloodstream that attack and grow on valve tissue
What are some ways that microorganisms can enter the bloodstream and cause endocarditis?
-dental work
-surgery
-IV drug use
What is Libman sachs also called?
Systemic lupus erythematosus
What is systemic lupus erythematosus also called?
Libmans sachs
What is Libman sacks Endocarditis ?
A form of non-bacterial endocarditis that is seen in association with systemic lupus erythematosus
What is a form of non-bacterial endocarditis that is seen in association with systemic lupus erythematosus?
Libmans sachs
What is Marantic ?
Non-bacterial endocarditis
Marantic endocarditis is also called?
NBTE- non-bacterial thrombotic endocarditis
What does NBTE stand for?
non-bacterial thrombotic endocarditis
NBTE or Marantic endocarditis is often seen in which patients?
Metastatic disease patients
What are the two most common bacteria that caused endocarditis?
- strep
-staph
_____ jets increase risk for endocarditis
High velocity
What increases your risk for endocarditis?
A) low velocity jets
B) exercise
C) high velocity jets
D) all of the above
C
Microorganisms seed on abnormal or normal_____
Endocardial surfaces
What are three examples of endocardial surfaces that microorganisms like to seed on?
- abnormal valves
-Prosthetic valves
-Rough surfaces caused by regurgitation jets
Microorganisms attached to the ____ side of the valve
Flow
Which side of the valve does endocarditis usually form on?
Flow side (upstream)
Endocarditis lesions like to attach to the ___ side of valves which is usually the ____ pressure side
Flow; lower
IV drug users are at ___% risk for ____ vegetarians
75%; tricuspid valve
What are some symptoms of endocarditis?
- fever
-murmurs
-tachycardia - anemia
In order to see 2-D vegetations on excel they must be what size?
A)2mm
B)5mm
C1mm
D)3mm
D
Vegetations nay embolism especially if they’re ___, ___ and ___mm or greater
Mobile, predunculated; 5mm
What size of vegetations does it make it more likely for it to become an embolus?
A) 2mm
B)3mm
C)5mm
D)1mm
C
True or false- we can tell between old and new vegetations on echo
False! We can’t tell
On echo vegetations appear as an area of?
A)decreased echoes
B) increased echoes
B
Oscillations of vegetations may be seen on m-mode usually when the valve is ___
Closed
With endocarditis leaflet disruption or ___ may occur
Flail leaflet
Vegetations on echo may have ?
A) shaggy appearance
B) dumbbell appearance
C) low echo appearance
D)none of the above
A
With endocarditis ____mitral closure may occur
Premature
What kind of valves are at increased risk for endocarditis?
Prosthetic valves
Blood cultures for endocarditis are usually ___% positive
90
Valves with endocarditis usually have____ lesions
Regurgitant lesions
If there’s a ring abscess around a valve it may have a ___ flowPattern
Continuous
