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Sem2: MDSA30160: Cardiorespiratory Disease > L8 Valvular and Congenital Heart Disease > Flashcards

L8 Valvular and Congenital Heart Disease Flashcards

1
Q

___________: failure of a valve to open completely (impedes forward flow)

A

Stenosis: failure of a valve to open completely (impedes forward flow)

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2
Q

_______________: failure of a valve to close completely (allows reverse flow)

Frequency of Involvement?

A

Incompetence (Insufficiency): failure of a valve to close completely (allows reverse flow)

Left Heart more prevalent

Mitral > Aortic

Right Heart less frequent

Tricuspid > Pulmonary

Can be Acquired or Congenital:

Acquired more common, typically post-inflammation

Typically in left heart due to higher pressure/ strain

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3
Q

Infective Endocarditis Findings?

A

Findings:

Sepsis

Murmur

Fever of Unknown Origin

Vegetations (1mm –4cm)

Necrosis/Perforation of Valve Tissue

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4
Q

__________________:

Difficult to diagnose

Fevers spike/ diminish

Subacute bacterial endocarditis

A

Insidious Onset (SBE) Endocarditis

Difficult to diagnose

Fevers spike/ diminish

Subacute bacterial endocarditis

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5
Q

___________

Rapidly fatal - early diagnosis essential

Acute bacterial endocarditis

A

Fulminant Onset (ABE) Endocardits

Rapidly fatal - early diagnosis essential

Acute bacterial endocarditis

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6
Q

Which valves are typically affected by endocarditis?

A

Left sided Valves >>> Right

Mitral Valve (bicuspid) > Aortic (often both)

Tricuspid Valve Endocarditis –“always” IV Drug Abuse

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7
Q

Risk Factors for Endocarditis?

A

Risk factors

Immunosuppression (except in AIDS)

Intravenous Drug Abuse (IVDA)

Any Low-Grade Chronic Bacteraemia

Preexisting Valvular Disease

  • Congenital
  • Rheumatic
  • Mitral Valve Prolapse
  • Prosthesis
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8
Q

Organisms involved in Infectious Endocarditis?

Different Valve types?

A

Organisms InvolvedTypically effects Valvular Endocardium

Normal Valve- Likely Staph Aureus

Diseased Valve - Less virulent organism (Streptococci)

Prosthetic Valve (Likely Staph Aureus)

HACEK Group

Fungi

10% culture negative

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9
Q

Complications of Endocarditis?

A

Complications

Valvular Insufficiency

Myocardial Abscess

Suppurative Pericarditis

Valve Dehiscence (rupture)

Embolic Disease –Brain, Kidney etc.

Infection elsewhere

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10
Q

Causes of Non-Infective Endocarditis

A

Rheumatic Fever/Valvular Heart Disease

SLE (Libman-Sacks) Endocarditis

Non-Bacterial Thrombotic Endocarditis

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11
Q

Rhematic Fever vs. Rhematic Heart Disease?

A

Acute (Rhematic Fever): multisystem

Chronic (Rhematic Heart Disease): valvular abnormalities, mainly mitral

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12
Q

Acute vs. Chronic Rheumatic Valvular Heart Disease

A

Acute:

Aschoff Bodies

Verrucous Vegetations: lines of valve closure –chordae tendineae

Chronic:

Fibrosis Scarring of Cusps/Chordae

=> Stenosis / Incompetence

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13
Q

Valves affected by Rhematic Valvular Heart Disease

A

Mitral >> Aortic >> Tricuspid >>> Pulmonary

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14
Q

Complications of Rheumatic Valvular Heart Disease

A

Complications:

Endocarditis

Cardiac Failure

Thrombosis/Embolisation

Pulmonary Hypertension

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15
Q

______________________:

  • Small, sterile, verrucous (warty looking) vegetations occurring on the surface of the MITRAL (more common) and TRICUSPID Valves
  • _________ Reduce Incidence
  • Regurgitation manifestation
A

SLE (Libman-Sacks) Endocarditis

  • Small, sterile, verrucous (warty looking) vegetations occurring on the surface of the MITRAL (more common) and TRICUSPID Valves
  • Steroids Reduce Incidence
  • Regurgitation manifestation
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16
Q

________________:

Calcified masses in cusps with fibrosis and degeneration

Congenital as a child

Calcification of Bicuspid Valve age 50-60

A

Aortic Stenosis (Sclerosis):

Calcified masses in cusps with fibrosis and degeneration

Congenital as a child

Calcification of Bicuspid Valve age 50-60

17
Q

_______________:

Connective Tissue abnormality

Variable severity

Idiopathic (unknown cause)

Some overlap w/ Marfans Syndrome

A

Mitral Valve Prolapse

Connective Tissue abnormality

Variable severity

Idiopathic (unkown cause)

Some overlap w/ Marfans Syndrome

18
Q

Ischemic (Papillary Muscle Infarction) => _____________

A

Ischemic (Papillary Muscle Infarction) => Mitral Regurgitation

19
Q

Dilated Mitral Valve Ring => ____________

A

Dilated Mitral Valve Ring => Mitral Regurgitation

20
Q

Examples of Degenerative Valvular Disease

A

Aortic Stenosis (Sclerosis)

Mitral Valve Prolapse

Ischemic (Papillary Muscle Infarction)

Dilated Mitral Valve Ring

21
Q

Two examples of congenital heart disease which present for the first time in adults?

A

–Mitral Valve Prolapse

–Bicuspid Aortic Valve

22
Q
A
23
Q

Types of Shunts?

A

Shunts

Left to Right Acyanotic

Right to Left Cyanotic (Eisenmenger’s Syndrome)

24
Q

_________________: due to an increase in pulmonary pressure, RV Hypertrophy exceeds LV pressure=> right to left shunt circulation leading to ___________

A

Eisenmenger’s Syndrome: due to an increase in pulmonary pressure, RV Hypertrophy exceeds LV pressure=> reversal right to left shunt circulation= Cyanosis: Dexoxygenated blood enters systemic ciruclation

25
Q

___________________:

Most common congenital abnormality

“Hole in Heart”

Small => ___________

Large => ___________

A

Ventricular Septal Defect

Most common congenital abnormality

“Hole in Heart”

Small => spontaneous closure

Large => Cardiac failure / Eisenmenger’s Syndrome

26
Q

What defect leads to Paradoxical Emboli?

A

Paradoxical Emboli (venous thrombus in systemic circulation) are caused by:

Atrial Septal Defect

4 Types (Based on Location)

Ostium Secundum (90%)

Ostium Primum (Downs Syndrome)

Sinus Venosus

Coronary Sinus

27
Q

_______________:

Physiologic Shunt in Utero

Contracts post partum after breathing start and fibroses (closes)

Can be kept open w/ ___________ for treatment of _______

A

Patent Ductus Arteriosus:

Physiologic Shunt in Utero

Contracts postpartum after breathing starts and fibroses (closes)

Can be kept open w/ Prostaglandins (Treatment of Cyanotic Congenital Heart Disease)

Allows oxygenated blood to mix with deoxygenated

28
Q

Congenital Aortic Stenosis

Supravalvular - ___________

Valvular– ____________

Subvalvular – ________

A

Congenital Aortic Stenosis

Supravalvular - hypercalcemia → Narrowing

Valvular– bicuspid valve stenosis

Subvalvular – fibrous band

29
Q

Coarctation of the Aorta characteristics?

A

Preductal (Ductus Arteriosus): Presents early in childhood

Postductal: Presents as adult, secondary hypertension

30
Q

Manifestations of Tetrology of Fallot

A
31
Q

Cyanotic Congenital Heart Diseases?

Treatment?

A

Tetrology of Fallot

Transposition of the Great Vessels

Treatment: Patent Ductus Arteriosus can be kept open w/ Prostaglandins allowing oxygenated blood to mix with deoxygenated

32
Q

Manifestations of Transposition of the Great Vessels?

A

Sem2: MDSA30160: Cardiorespiratory Disease (24 decks)

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