L3 - Valvular heart disease

Question 1

Describe composition of valves?

Answer 1

1. Ventricularis: collagen, elastin
2. Fibrosa: dense collagenous core
3. Spongiosa: core of loose connective tissue
4. Atrialis: layer rich in elastin, endothelial covering

Question 2

What is mainly responsible for the mechanical integrity of a valve?

note:
what allows valve to adapt?

Answer 2

• collagen
• valve populated by interstitial cells
• produce and repair ECM
• allowing valve to adapt

Question 3

Stenosis

Answer 3

failure of valve to open completely.

impedes forward flow.

pressure overload.

Question 4

Insufficiency

Answer 4

failure of valve to close completely.

allowing reversed flow.

volume overload.

Question 5

Describe three main types pathologic changes of valve?

include examples

Answer 5

1. damage to collagen, weakening leaflets, mitral valve prolapse
2. nodular calcification beginning in interstitial cells, calcific aortic stenosis
3. fibrotic thickening, rheumatic heart disease feature

Question 6

aortic stenosis

- symptoms (3)

Answer 6

• dysponea
• syncope
• angina

Question 7

pathophysiology of acute aortic regurgitation?

Answer 7

• sudden large regurgitant vol imposed on LV (of normal size and compliance)
• LV attempts to maintain CO with increased HR and contractility
• compensatory LV dilation, hypertrophy

Question 8

Describe what may happen if attempts to maintain forward SV/CO may be inadequate?

Answer 8

1. Pulmonary oedema
2. cardiogenic shock
3. angina