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Vascular system and medical emergencies (DEN305) > Pathology of valvular heart disease > Flashcards

Pathology of valvular heart disease Flashcards

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USMLE® Step 1 flashcards
1
Q

What can go wrong?

A

Stenosis

Incompetence (systole)

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2
Q

Stenosis

A

When the valve won’t open properly

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3
Q

Incompetence (systole)

A

Valve becomes leaky

Lets blood back through

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4
Q

What causes the problems?

A

Rheumatic fever
Calcific aortic valve disease
Age-related degeneration

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5
Q

Rheumatic fever

A

Infection that damages the heart valves

Streptococcal pharyngitis

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6
Q

Rheumatic fever bacteria

A

Strep. pyogenes

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7
Q

Streptococcal pharyngitis –>

A

Immune reaction by body

  • -> cross reaction with self antigens leading to:
  • endocarditis
  • myocarditis
  • pericarditis
  • polyarthritis
  • subcutaneous nodules
  • erythema marginatum
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8
Q

Valve fibrosis after rheumatic fever

A

If valve fibrosis at all
Mitral valve 90%
Aortic valve 40%

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9
Q

Calcific aortic valve disease

A

Deposit calcium in aortic valve, generally causes it to be stenotic

  • rigid valve cusps
  • stenotic valve
  • LVH
  • inadequate coronary artery perfusion
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10
Q

Degeneration of the mitral valve

A

Floppy mitral valve

Causes?

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11
Q

Prosthetic valve disease types

A 
Biological
-human
-porcine
Artificial
-tilting disc
-ball & cage
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12
Q

Biological prosthetic heart valve

A

Patients own tissue
Blood can flow through it
Pts don’t need anticoagulation
Calcify up in around 10 years (good for older people)

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13
Q

Prosthetic heart valve complications

A 
–haemolysis
–coagulation
–anti coagulation therapy
–mechanical failure
–calcification
–infective endocarditis
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14
Q

Infective endocarditis and rheumatic fever

A 
Infective endocarditis is not
rheumatic fever
Valve damage due to
rheumatic fever predisposes
to infective endocarditis
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15
Q

Infective endocarditis - sites

A 
Any abnormal heart valve
–all pathologies mentioned so far
–prosthetic heart valves
Tricuspid valve
–intravenous drug users
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16
Q

Complications of infective endocarditis

A 
Local
–valve incompetence
–myocarditis
Systemic
–emboli
–general effects of systemic infection
–glomerulonephritis (immune complex depositio
17
Q

What does infective endocarditis look like?

A

Vegetations composed of fibrin and bacteria

Grow on valve and destroy it

18
Q

Systems effects of infective endocarditis

A

Splinter haemorrhage in nailbed
Osler’s nodes
Embolic infarct in kidney
Embolic infarct in spleen

19
Q

Infective endocarditis causative organisms

A

Oral cavity - Strep viridans
IV drug users - Staph. aureus
Aspergillus

Vascular system and medical emergencies (DEN305) (5 decks)

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