Lecture 20 - Valvular Disease Flashcards
______ ______ Stenosis is the most common of all valvular diseases. People with __-cuspid aortic valves are more susceptible to this disease (it occurs most often between ages 50-70 for these patients.)
Calcific Aortic Stenosis
Bicuspid
How does Commissure fusion differ in Calcific Aortic Stenosis vs Rheumatic Heart disease?
They are usually NOT fused in Calcific Aortic Stenosis. The opposite is true for Rheumatic Heart Disease.
Due to the increase in pressure in Calcific Aortic Stenosis, the Left Ventricle undergoes ______ hypertrophy.
Concentric
The _____ of the valve is a major site of Calcific deposits in Calcific Aortic Stenosis.
Raphe
Mitral Valve prolapse is often an _______ (purposeful or incidental?) finding, particularly in ____ (young or old?) women. It presents with a mid _____ (systolic or diastolic?) click. The chordae tendinae become elongated and _____ (thick or thin?), and the leaflets balloon and thicken.
Microscopically, there is marked thickening of the ______ layer with mucoid deposition.
Incidental
Young women
Systolic click
Thin
Spongiosa layer
Mitral Valve Prolapse is associated with heritable disorders of connective tissue, including _____ Syndrome –> Defect in FBN-1 and disregulation of ____-beta signalling.
Marfan Syndrome
TGF-beta
Rheumatic Heart Disease typically occurs a few weeks after group A Strep ______ (rarely follows infections at other sites.) Look for patients to present with Subcutaneous _____, erythema ______, Chorea, and migratory ________.
Strep A Pharyngitis
Subcutaneous Nodules
Erythema Marginatum
Migratory Polyarthritis
_____ bodies are a hallmark microsopic finding for Rheumatic heart disease. “Laughing your ______ at Anitschkow (Caterpillar cell).”
Aschoff
Laughing your Aschoff at Anitschkow
Infective Endocarditis can be protected against with Antibiotic prophylaxis. The source of the pathogen can be from infection elsewhere in the body, but be on the lookout for patients who recently had _____ work done.
Dental
Acute bacterial endocarditis is more destructive and rapidly progressing than Subacute Bacterial Endocarditis, which typically affects previously _____ or _____ valves.
______ ______ is responsible for MOST of the cases and can affect normal valves. _____ _____ is responsible for fewer cases and typically affects previously _______ or ______ valves.
Damaged or Deformed
Strep aureus
Strep viridans
Damaged or Deformed
Prosthetic valve endocarditis is most commonly caused by _____-negative Staph.
Coagulase-negative
Emboli are among the risks from bacterial endocarditis, and they can cause _______ to form at the sites where they end up. They can also lead to septic infarcts or mycotic aneurysms.
Abscesses
Nonbacterial Thrombotic Endocarditis (aka Marantic endocarditis) occurs in debilitated patients (usually suffering from cancer or sepsis). Their sickness puts them in a hyper-________ state, thus leading to thrombi formation. ________ syndrome of migratory thrombophlebitis is caused by the procoagulant effects associated with malignancy. The hearts of these patients present macro and microscopically with sterile vegetations mostly made of ______.
Hypercoaguable state
Trousseau Syndrome
Fibrin
Libman-Sacks Endocarditis occurs in patient suffering from _____. This is another sterile vegetative endocarditis. It can resemble Chronic Rheumatic Heart Disease, so be on the lookout for _______ bodies in the bone marrow of these patients.
SLE
Hematoxylin bodies
Carcinoid Heart Disease (carcinoids are tumors of neuroendocrine cells) affects the ______ side of the heart because the bioactive products the carcinoid cells make are broken down in the _____.
Right side
Lungs
