Mod8(valvular,pericardial heart disease) Flashcards
Mitral Stenosis
restriction of mitral valve opening that impedes diastolic blood flow from the left atrium to left ventricle; dilation of left atrium from volume overload
Mitral Regurgitation
occurs when valve is compromised in some way causing retrograde blood flow from left ventricle to left atrium during ventricular systole; atrial fibrillation
Tricuspid Stenosis
restriction of tricuspid valve opening that impedes diastolic blood flow from right atrium to right ventricle
Tricuspid Regurgitation
Occurs when valve is compromised causing retrograde blood flow from right ventricle to right atrium during ventricular systole; see RA enlargement from vol overload
Aortic Stenosis
narrowing and restriction of aortic valve opening that impedes systolic blood flow from left ventricle into aorta; aortic leaflets thicken leading to greater resistance for LV to pump therefore LV enlarge and LA dilate
Aortic Regurgitation (insufficiency)
occurs when valve is compromised in some way, causing retrograde blood flow from aorta to LV during diastole; LV enlargement (from vol overload) and LA enlargement, tachycardia and atrial fibrillation in chronic AR
Pulmonary stenosis
narrowing of pulmonary orifice impeding blood flow from RV during systole; right valvular hypertrophy and RA dilation
Pulmonary regurgitation (insufficiency)
occurs when valve is compromised causing retrograde blood flow from pulmonary artery back in RV during diastole; may indicate pulmonary hypertension; will see RV hypertrophy and RBBB
Cardiomyopathies
dysfunction restricted to the myocardium that is UNRELATED to ischemic, valvular, hypertensive, pericardial or congenital heart disorders.
Pericarditis
inflammation of pericardial layers; may cause visceral pericardium to secrete additional fluid resulting in pericardial effusion
how the valves work
blood flow through AV valves (tricuspid/mitral) during diastole and blood flow through semilunar valves (pulmonic/aortic) during systole
Stenosis
impeded blood flow; therefore will see enlargement from pressure/volume overload in atria/ventricles; #1 cause of stenosis in valves is rheumatic heart disease
- Dilated Cardiomyopathy (DCM)
ventricular enlargement; dilation of mitral and tricuspid valve leads to MR and TR; high risk of thromboembolism due to stagnant blood pooling in poorly contracting ventricles and dilated atria
Symptoms of DCM
Low CO (fatigue, lightheaded, exertional dyspnea), and Pulmonary congestion symptoms (dyspnea, orthopnea, pulmonary rales, peripheral edema)
- Hypertrophic Cardiomyopathy (HCM)
LV hypertrophy; impaired diastolic relaxation from LV stiffening- 3 types
Obstructive hypertrophic cardiomyopathy (HOCM)
subaortic due to systolic anterior motion of mitral leaflet ; **with obstruction will show BISFERIENS CAROTID (double beat over carotid); will see LA and LV enlargement with obstruction
Mid Ventricular Obstructive hypertrophic cardiomyopathy
at level of papillary muscles
Non-Obstructive hypertrophic cardiomyopathy (HCM)
no resting obstruction
Restrictive Cardiomyopathy (RCM)
increased resistance to ventricular filling due to myocardial stiffening; systolic function is unaffected; presents the same as constrictive pericarditis
RCM symptoms
low CO (fatigue, lightheaded, dyspnea), Pulmonary congestion symptom (JVD, ascites, peripheral edema, pulmonary rales)
Acute Pericarditis
most common type of pericardial disease; will see positional sharp pleuritic chest pain, pericardial friction rub (from inflammation)
Constrictive Pericarditis
pericardial disease; restriction of diastolic filling of heart caused by thickening fibrosis and adhering of pericardium; will see exertional dyspnea, chronic fatigue, JVD, HF, peripheral edema
Peripheral Effusion
pericardial disease; accumulation of fluid in pericardial space; experience dull left side angina, dysphagia (swallowing) and dyspnea; soft heart sounds, decreaed intensity of friction rub, ewart signs (dull left lung sound)
three factors that determine if peripheral effusion progresses to tamponade
volume of fluid, rate of fluid accumulation and pericardium compliance (***ECHO is most useful to evaluate whether pericardial effusion has haemodynamic consequences leading to tamponade)
Pericardial Tamponade
accumulation of fluid causing elevation of intrapericardial pressures causing elevation and equalization of intracardiac pressure; compromises cardiac chamber and limits ventricular filling; immediate treatment to remove fluid
