Valve Disease Flashcards
What is the order of the blood flow through the valves?
tricuspid–> pulmonary–> mitral–> aortic
Tricuspid Valve: Location
between right atrium and right ventricle
Pulmonary Valve: Location
exiting valve between right ventricle and pulmonary artery
Mitral Valve: Location
between left atrium and left ventricle
Aortic Valve: Location
exiting valve between left ventricle and aorta
While three of the valves have 3 “leaflets”, which one only has 2 “leaflets”?
mitral valve
When do the tricuspid and aortic valves open and close?
- open during systole
-allow blood flow from the contracting ventricles out of the heart
-close with diastole
-can tell you about symptomology if these valves are damaged
Valve Abnormalities (5)
wear and tear
calcification
pannus
endocarditis
thrombus
Valve Abnormalities
leads to stenosis or regurgitation
stenosis: very tight and hard for the blood to get through
regurgitation: very loose and the blood flows backward with increased pressure
Stenosis often affects what valve?
aortic
Regurgitation usually affects what valve?
mitral
Aortic Stenosis: Definition
blood is unable to flow freely from the left ventricle to the aorta
Aortic Stenosis: Symptoms (4)
often asymptomatic
syncope
light headedness
chest pain
pulmonary edema
-sound/look like:
rhonchi, crackles,
cough, pulmonary
congestion
Mitral Regurgitation: Definition
blood leaking back through the mitral valve into the left atrium (aka mitral valve insufficiency)
can be acute or chronic
Mitral Regurgitation: Symptoms (2)
fatigue
SOB
Infective Endocarditis (IE)
infection on the valve itself or you get vegetations on the valve
these pieces of vegetation can actually break off during contraction and travel to other places
-lungs
-brain or somewhere
else in the body
-can become SEPTIC
EMBOLI
IE commonly affects which valve?
tricuspid
IE: Risk Factors (3)
prosthetic valve
pacemaker-associated
IV drug abuse (IVDA)
IE: Symptoms
fever
chills
anorexia
weight loss
myalgias: pain in muscles
arthralgias: joint pain
heart murmur
-depending on which valve is affected, signs of ischemia or infarction of the extremities, spleen, kidney, bowel, or brain may be the initial CM of IE
-septic emboli can lodge in a cerebral artery or arteriole and cause an ischemic stroke. NEUROLOGICAL symptoms from embolic stroke occur in up to 40% of pts. with IE
-Pts. may also present with meningitis, seizures, encephalopathy, or abscesses of the brain
Septic Emboli in IE: Patho
microorganisms travel into the heart, adhere to damaged endothelial tissue, and attract WBCs and platelets, which release cytokines and coagulation factors–> stimulation of the coagulation cascade results in fibrin deposition, and development of a vegetation–> fragments of vegetations can embolize into the circulation—-> carried by the bloodstream, they can initiate infection or ischemia in remote tissues
Vegetations are most commonly found on _____
valve leaflets
IE: Septic Emboli: Classic CM (5)
-petechiae
-splinter hemorrhages
(linear streaks in the
nailbeds)
-Janeway lesions
(erythematous,
nontender lesions on the
palms and soles)
-Osler’s nodes
(subcutaneous nodules
in the pulp of the
fingertips)
-Roth spots
(oval retinal
hemorrhages with pale
centers)
IE in IV Drug Abusers
-the veins are portal of entry, and S. aureus, the flora of the skin, most commonly causes bacteremia
-S. aureus travels from the peripheral vein into the inferior vena cava and into the right side of the heart
-the tricuspid valve is most often affected in IV drug users (blood flow goes through this valve first)
-septic emboli can enter the pulmonary artery–> lungs
