pathology of acquired heart disease Flashcards
Three thin, delicate cusps with orifices of the coronary arteries
aortic valve
component of valves (4)
- fibrosa- dense collagenous core
- spongiosa- central core
- atrialis- elastic rich layer
- ventricularis- elastic rich layer
which 2 cardiac valves are most commonly involved with acquired diseases
aortic and mitral
effects of mitral stenosis
back up of blood in the LA and the pulm. vasculature
- Pulm. edema
late stages of mitral stenosis
- RV failure
- congestion of the liver
mitral regurg. effects
- increased LV workload leading to LV hypertrophy and failure
effects of aortic stenosis
LV hypertrophy and failure
effects of aortic incompetence
volume overload
main cause of aortic regurg
HTN used to be Rheum. fever
late effects of aortic regurg
LV hypertrophy and failure
most common valvular diseases
calcific aortic stenosis and MVP
most common cause of mitral stenosis
rheum. fever
major causes of valve disease
- aging
- congenital
- Rheum. fever
- infective endocarditis
- non-infective vegetations
BAV predisposed one for calcification?
yep
calcific stenosis we see a gradual increase of _________ and ________
LV outflow obstruction and pressure load
myxomatous degeneration of the mitral valve floppy valve disease
MVP
MVP:
- occurs primarily on
- what do we hear?
- uncommonly associated with
- complications
- young females
- midsystolic click- barlow’s syndrome
- marfan’s syndrome
- Mitral regurg., emboli, infective endocarditis, arrhythmia
acute, immune mediated, multisystemic inflammatory disease
rheumatic fever
Rheum fever:
- acute effects on
- caused by
- what happens?
- heart, joints, skin and brain
- group A- Beta hemolytic streptococcal pharyngitis– pyrogenes
- anti-strept ab produced and they cross react with glycoproteins
diagnosing rheum. fever
- Jones’ criteria
- how mant major vs minor?
- Major: migratory polyarthirits of large joints, carditis, subcutaneous nodules, erythmea marginatum, sydenham’s chorea
Minor: fever, ESR… - 2 major or 1 major and 2 minor
effects on heart are cimulative with rheum. fever?
yep
Rheum. fever histo
- aschoff nodule
- anitschkow cells
rheumatic endocarditis
vegetation on closure line of cusps
infection of valves or other parts of endocardium
infective endocarditis
splinter hemorrhage
infective endocarditis
organisms of infective endocarditis
alpha- hemolytic strpt- viridians
bulky friable destructive vegetations that occur everywhere on valves
infective endocarditis
enfective endocarditis affects _____ valves
– mitral and aortic valves even in IV drug use
infective endocarditis
- consists of
- complications
- fibrin, inflammatory cells and bacteria–> fibrosis and calcification
- suppurative pericarditis, valve destruction, ring abscesses and septic emboli
non-bacterial thrombotic endocarditis
- causes
- vegetations where?
- SLE and hypercoagulable states, malignancy and sepsis
2. undersurfaces of mitral valves
libman sacks endocarditis
associated with SLE; vegetations on mitral and tricuspid valves
fibrinoid material with inflammation and hematoxyphil bodies with multiple sterile pink verrucous vegetations
SLE in NBTE
What accounts for the majority of acquired valvular diseases in the United States
Acquired stenosis of the aortic and mitral valve account for 2/3 of valvular diseases
Mitral valve stenosis leads to which changes in the lung, heart and liver?
Pulmonary edema, right ventricular failure and congested liver
What characterizes calcific aortic stenosis?
Degeneration of the valve with calcifications
What valve abnormality leads to the “hooding” seen in mitral valve prolapse
Myxomatous degeneration of the valve
What characterizes an Aschoff nodule?
Fibrinoid necrosis surrounded by inflammatory cells
What are the major differences between acute and subacute endocarditis?
Acute : normal valve, virulent organism, marked destruction, high mortality
Subacute: abnormal valve, low virulence of organisms, less destruction, low mortality
