(P4) Cardiac: Rheumatic endocarditis Flashcards
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Rheumatic endocarditis
- fibrinoid necrosis
- deposition of small sterile vegetations on valvar leaflets*
- fibrinoid necrosis
- Valvular deformation (mitral/aortic insufficiency/stenosis*
- Mitral Valve*
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Identify slide:
This lesion is the most common manifestation of what….and a consequence of the progresson of what…which involves what?
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Rheumatic endocarditis
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- • Rheumatic endocarditis is the most common manifestation of rheumatic heart disease*
- • Rheumatic heart disease is a consequence of the progression of acute rheumatic fever*
- • Usually involves mitral valve (the only cause of mitral stenosis)*
Rheumatic endocarditis
Macroscopic findings
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The cardinal anatomic changes of the mitral valve in chronic RHD are:
– leaflet thickening
– commissural fusion
– shortening, thickening and fusion of the tendinous cords
- Mitral valve is always involved (in 2/3 of cases it is the only valve involved) and it leads to mitral stenosis
- With tight mitral stenosis* the *left atrium progressively dilates* and may *harbor mural thrombi
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identify slide
Describe the physiological involvement
and
location
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- Rheumatic endocarditis*
- -Valvular involvement left sided valves*
- -Involvement of endocardium*
- and*
left-sided valves – mitral valve
- -Damage of endothelium promotes fibrinoid necrosis*
- -Formation of thrombi/emboli Perivascular region. -Inflammation concentrated near valve*
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Rheumatic endocarditis
describe what is found within the cusps or along the tendinous cords and at sites of erosion:
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–Inflammatory foci’s fibrinoid necrosis within the cusps or along the tendinous cords–Nonspecific chronic inflammation
–Small vegetation nodules 1-2mm – precipitation fibrin at sites of erosion with inflammation and collagen degeneration
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Rheumatic endocarditis
leads to?
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- Leads to stenosis or deformation of the valve
- Exudative & proliferation inflammation, valve involvement (left side)
- Fibrinoid necrosis
- Small thrombus (blood, platelets & fibrin) at the site of erosion w/inflammation
- Fibrous thickening of valve→stenosis or deformation of valve
![](https://s3.amazonaws.com/brainscape-prod/system/cm/405/726/924/a_image_thumb.png?1613247740)
Rheumatic endocarditis
Microscopy?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/405/726/927/q_image_thumb.png?1613247765)
Normal myocardium.
Valve w/ large foci of fibrinoid necrosis
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Name Slide:
Chronic direct consequence of this lesion is?
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Rheumatic endocarditis
Valvular deformation (mitral/aortic insuficiency/stenosis)
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Anatomical structure of the presented organ
(not the histological layer indicated by the name of disease!)
typically affected by this lesion is?
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Rheumatic endocarditis
Mitral valve (left-sided valve)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/405/726/932/a_image_thumb.png?1613248201)
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identify structures
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identify structures and slide
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Rheumatic endocarditis
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Rheumatic endocarditis
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