Unit 1 Day 8 Wed (4/1/15)

Question 1

HDAC9

Answer 1

• over expression of this gene blcoks cardiomyocyte hypertrophy in mice
• HDAC knockdown stimulates hypertrophy
• epigenetics plays role in cardiac health

Question 2

Aortic Valve Diseases

Answer 2

• aortic stenosis

- aortic regurgitation

Question 3

Pulmonic Valve Diseases

Answer 3

-pulmonic stenosis

Question 4

Aortic Stenosis

Answer 4

• tricuspid valve
• types: calcific (most common), bicuspid, rheumatic
• risk inc. with age
• survival dec. with onset of sx
• sx: angina, syncope, shortness of breath
• dx: echo w/ doppler
• tx: replacement with mechanical or bioprosthetic valve for pts with sx

Question 5

Aortic Regurgitation

Answer 5

• can be due to valve disease or disease of the aorta
• signs-
  
  • corrigans pulse
  • quickes pulse
  • de Mussets sign (bobbing head)
  • durozies sign (femoral bruits)
  • hills sign (sustolic BP in legs >30 mmHg than arms)

Question 6

Pulmonic Stenosis

Answer 6

• common form of congenital heart disease
• more common in young people
• tx: balloon valvuplasty

Question 7

Mitral Valve Stenosis

Answer 7

• dec. mitral valve opening during diastole
• cause: rheumatic (most common), calcific
• symptoms: dyspnea, hemoptysis, pulmonary hypertension, R sided HF, atrial fibrillation, thromboembolic event
• signs: loud S1, opening snap, diastolic rumble, L atrial enlargement
• dx: echo
• tx: meds (beta blockers, diuretics, anticoagulants), valve replacement, balloon valvuloplasty

Question 8

Mitral Valve Regurgitation

Answer 8

• failure of mitral valve to close during systole, allowing blood to flow back to atrium
• etiology: prolapse (most common), ischemic heart disease, endocarditis, LV enlargement
• signs: holosystolic murmur at apex, congestive HF
• symptoms: most often asymptomatic
• prognosis: good
• tx: meds (diuretics for CHF, afterload reduction (ACE, ARBs), surgery, mitraclip

Question 9

Tricuspid Regurg

Answer 9

• during systole, valve does not close and blood flows back into R atrium
• cause: structural abnormality, acquired, functional (most common)
• signs: JVD with V wave, hepatomegaly, holosystolic murmur on sternal border worse with inspiration
• symptoms- fatigue, abdominal fullness, edema, palpitations, hepatic congestion
• tx: tx underlying cause, diuretics, surgery

Question 10

Tricuspid Stenosis

Answer 10

• rare!
• cause: rheumatic heart disease most common
• tx: diuretics, surgery