Lec 2B: Pathology of heart valve diseases

Question 1

Third sound that heart makes?

Answer 1

rapid passive filling phase of ventricular diastole

Question 2

4th heart sound?

Answer 2

atrial contraction

Question 3

Valvular stenosis?

Answer 3

Having a hard time opening. When the valve does not open properly.

Question 4

Valvular Regurgitation/imcompetence/insufficiency?

Answer 4

occurs when valve does not close properly –this frequently results in the backflow (regurgitation) of blood.

Question 5

What happens when you have a valve problem?

Answer 5

Leads to myocardial hypertrophy. This is to compensate to increase the pumping capability of the heart.

Question 6

What is the cause of valvular heart disease? Result from what disease?

Answer 6

late result of rheumatic fever. 2ndary to other inflammatory processes.
-Sometimes is congenital (birth)

Question 7

Can valvular heart disease occur with prosthetic cardiac valves?

Answer 7

yes –> physical deterioration or can be the site of thrombus formation or infectious endocarditis.

Question 8

What is rheumatic fever?

Answer 8

multisystem inflammatory disorder with major cardiac manifestations and sequelae,

• often affects children from 5-15 years of age
• usuall occurs 1-4 weeks after tonsillitis or other infection caused by group A beta-hemolytic steptococci.
• Can lead to endocarditis, can lead to valvular damage.
• mitral valve most often affected.

Question 9

What is Mitral stenosis?

Answer 9

Impairment of blood flow from left atrium to left ventricles

• results to less ventricular filling
• decreased SV (Stroke volume) and decreased CO.

-results to increase LA pressure and hypertrophy, LV hypertrophy, and increased risk of atrial dysrhythmias.

Question 10

Chronic rheumatic heart disease?… can lead to what?

Answer 10

can lead to mitral stenosis –> diffuse fibrous thickening and distortion of the valve leaflets.

Question 11

What damageas are seen in mitral valves as a result of rheumatic fever?

Answer 11

1) infection may cause leaflets of valve to thicken, limiting valve’s ability to open.
2) infection may cause leaflets of mitral valve to fuse somewhat together, preventing valve from opening and closing properly.
- - people with rheumatic fever may have both mitral valve stenosis and regurgitation.

Question 12

What is mitral insufficiency (prolapse)?

Answer 12

– Some of blood ejected during ventricular systole is forced into the left atrium (instead of out of the aorta).

-This results to decreased in SV, CO and increased in LV hypertrophy.

Question 13

What’s the most frequent heart valve problem, occuring in approx. 7% of population, most often in young woman?

Answer 13

• mitral insufficiency (prolapse)

Question 14

What can cause mitral insufficiency (prolapse)?

Answer 14

1) Rheumatic fever
2) infective endocarditis
3) wear and tear on valve
4) prior heart attack
5) untreated high blood pressure
6) congenital heart defects

Question 15

What happens in aortic stenosis?

Answer 15

• diminished blood flow from the left ventricle into the aorta
• results in decreased SV and CO, also fait pulses
• LV hypertrophy develops which increases myocardial oxygen demand.

Question 16

Main causes of aortic stenosis?

Answer 16

Birth d3) efect of aortic valve: valve normally has 3 cusps… so in aortic stenosis, the aortic valve only has 1 cusp or stenotic at birth.

• a bicuspid (two-part) aortic valve with progressive tear and wear.
  2) rheumatic heart disease.
  3) Normal aortic valve –> age-related degenerative change.

Question 17

What is degenerative calcific aortic stenosis?

Answer 17

Ca2+ gets collected .. deposits in leaflets.

Question 18

What is aortic insufficiency?

Answer 18

Blood ejected during ventricular systole flows back into left ventricle during ventricular diastole
– increased ESV, decreased SV and CO, and LV hypertrophy.

Question 19

Main cause of aortic insufficiency?

Answer 19

congenital heart defect
deterioration of valve with age
infective endocarditis
rheumatic heart disease.

Question 20

What are the names of the 2 prosthetic heart valves?

Answer 20

• tilting disc valves (single leaflet)
• Bileaflet valves
• left sided valve problems more common than right sided.