Structural cardiac abnormalities Flashcards
What are examples of valvular disease(4)
Aortic stenosis
Aortic regurgitation
Mitral stenosis
Mitral regurgitation
What does stenosis of valves mean
The valves do not open properly
What does valve regurgitation mean
the valves do not close properly
What are the types of aortic stenosis (3)
degenerative
Congenital
Rheumatic
What are the symptoms of aortic stenosis (3)
breathlessness
Chest pain
Dizziness/syncope
What are the signs of aortic stenosis (3)
low volume pulse
Forceful displaced apex
Ejection systolic murmur (may radiate to carotids)
What are the treatment options fro aortic stenosis (3)
conventional valve replacement
Trans-catheter aortic valve replacement (TAVI)
Balloon aortic valvotomy (BAV)
What are the causes of aortic regurgitations(5)
leaflets (valves)
- endocarditis
- connective tissue diseases
- rheumatic
Root
- marfan’s sydnrome
- aortic dissection
What are the symptoms of aortic regurgitation (2)
breathlessness
Angina
What are the signs of aortic regurgitation (3)
collapsing pulse
Displaced apex
Early diastolic murmur (heard at left sternal edge)
What treatment is used for aortic regurgitation (2)
ACE inhibitors
Valve replacement
What are the causes of mitral stenosis and which one is more common (2)
rheumatic (most common)
Congenital
What are the symptoms of mitral stenosis (3)
breathlessness
Fatigue
Palpitations
What are the types of valvular heart disease (4)
aortic stenosis
Aortic regurgitation
Mitral stenosis
Mitral regurgitation
What does valve stenosis mean
The valves do not open properly
What does valve regurgitation mean
the valves do not close properly
What are the types of aortic stenosis (3)
rheumatic
Degenerative
Congenital
What are the symptoms of aortic stenosis (3)
breathlessness
Chest pain
Dizziness/syncope
What are the signs of aortic stenosis (3)
low volume pulse
Forceful displaced apex
Ejections systolic murmur (may radiate to carotids)
What treatment is used for aortic stenosis (3)
Conventional valve replacement
Trans catheter aortic valve replacement (TAVI)
Balloon aortic valvotomy (BAV)
What are the causes of aortic regurgitation (5)
leaflets (valves)
- endocarditis
- connective tissue diseases
- rheumatic
Roots
- marfan’s syndrome
- aortic dissection
what are the symptoms of aortic regurgitation (2)
breathlessness
Angina
What are the signs of aortic regurgitation (3)
collapsing pulse
Displaced apex
Early diastolic murmur
What treatment is used for aortic regurgitation (2)
ACE inhibitors
Valve replacement
what are the causes of mitral stenosis and which is more common (2)
rheumatic (more common)
Congenital
What are the symptoms of mitral stenosis (3)
breathlessness
Fatigue
Palpitations
What are the signs of mitral stenosis (3)
malar flush
Tapping apex beat
Mid-diastolic rumbling
What treatment use used for mitral stenosis (4)
diuretics
Drugs to treat atrial fibrillation
Valve replacement
Balloon valvuloplasty
What are the causes of mitral regurgitation (4)
Leaflets (rheumatic, endocarditis etc)
Chordae rupture
Papillary muscle rupture
Annular dilation
What are the symptoms of mitral regurgitation (3)
breathlessness
Peripheral oedema
Fatigue
What are the sings of mitral regurgitation (2)
displaced apex
Pan-systolic murmur
What are the treatment options for mitral regurgitation (5)
diuretics
ACE inhibitors
Repair
Replacement
Percutaneous
What treatment option is used for prolapse mitral regurgitation
Valve repair
What treatment option is used for degenerative mitral regurgitation
valve replacement
What are the types of prosthetic heart valves (2)
mechanical
Bio-prosthetic
Describe mechanical prosthetic valves (3)
long-lasting
Require use of warfarin
Normally used for younger patients
Describe bio-prosthetic valves (3)
Last ~10 years
don’t require use of warfarin
Used for older patients
What are examples of non-ischaemic heart diseases (6)
Cardiomyopathy
Endo/myo/peri - carditis
Carcinoid heart disease
Tumours
Arrhythmias
Valvular disease
What is cardiomyopathy (2)
any disease of cardiac muscle
Often results in changes in the size of the chambers and the thickness of the heart
What are the types of cardiomyopathy (5)
dilated
Restrictive
Hypertrophic
Arrhythmogenic right ventricular dysplasia
Amyloidosis
Describe dilated cardiomyopathy (3)
the heart is 2-3 times the normal size
The heart is flabby and floppy
Hypertrophic changes
What are the clinical features of dilated cardiomyopathy (3)
(general picture of heart failure)
Shortness of breath
Poor exercise tolerance
Low ejection fraction
What are the causes of dilated cardiomyopathy (4)
genetics
Toxins
Infection
Childbirth
Describe restrictive cardiomyopathy (4)
stiff heart
Lack of compliance
Does not fill well (diastolic dysfunction)
Bi-atrial dilatation due to back pressure
What are the causes of restrictive cardiomyopathy (6)
Deposition
Metabolic byproducts
Amyloid
Sarcoidosis
Tumours
Radiation fibrosis
Describe hypertrophic cardiomyopathy (3)
strong contraction
Diastolic dysfunction
Outflow obstruction (eventually)
What is the cause of hypertrophic cardiomyopathy
Genetic
Describe Arrhythmogenic right ventricular dysplasia cardiomyopathy
the right ventricle is largely replaced by fat
What are the clinical signs of arrhythmogenic right ventricular dysplasia (2)
syncope
Arrhythmia
What is the cause of arrhythmogenic right ventriclar dysplasia
genetics (autosomal dominant, low penetrance)
What are the causes of myocarditis (4)
Infectious (all infectious agents)
Immune-mediated hypertensive reactions to drugs
“ “ to infections
Lupus
What are the types of pericarditis (2)
serous (low protein content)
Suppurative
What are the causes of pericarditis (5)
infection
Immune mediated
Connective tissue disorder (SLE)
Extension of inflammation after MI (Dressler’s syndrome)
Uraemia
Describe what happens in Dressler’s syndrome (simple)
the damaged heart muscle from MI releases material (which is previously unencountered) that stimulates an immune response
Describe infectious endocarditis (2)
aggregation of colonies of valves (vegetations)
These vegetations are friable and can cause emboli
Describe non-infectious endocarditis (4)
multiple small, sterile vegetations
Vegetations do not destroy valves
Vegetations can cause embolic disease
Usually occurs during a hypercoagulable state
What is non-bacterial thrombotic endocarditis associate with (2)
cancer and sepsis
What is carcinoid heart disease (2)
when neoplasms of neuroendocrine cells occur
Right sided cardiac valve disease
What are the symptoms of carcinoid heart disease (4)
skin flushing
Nausea
Vomiting
Diarrhoea
what are tumours of the myocardium called
Rhabdomyomas
What are tumours of blood vessels called (2)
angiomas
Angiosarcomas
What can myxoma cause (2)
valve obstruction
Myxoid emboli
What are the symptoms of myxomas (2)
fever
Malaise
Carney’s syndrome
multiple myxomas
What are examples of types of inherited cardiac conditions (3)
cardiomyopathy
Channelopathy
Aortopathy
What causes channelopathies
Mutations in genes which encode cardiac ion channels
What are examples of channelopathies (2)
congenital long QT syndrome/cLQTS
Brugada syndrome
What organisms is associated with infective endocarditis in patients with no past medical history
staph aureus
which condition is likely to cause a fourth heart sound
aortic stenosis
Which condition is most likely to cause a widely split S2
mitral regurgitation
Which organism is associated with infective endocarditis in patients with a prosthetic valve surgery 2 months ago
staphylococcus epidermidis
