valve disease

Question 1

heart valves

Answer 1

tri -> pulm -> mitral -> aortic
AV: tri, mitral
ventricular: pulm, aortic
Pulm and aortic open during systole to allow BF from contracting ventricles out of heart, close with diastole

Question 2

valve abn

Answer 2

damage = leaflets cant open/close
wear and tear -> lots of use
calcification -> Ca deposits
pannus -> issue with ring of valve - leaflets dont close
endocarditis -> valve infection, replacement
thrombus -> clot formation on valve
usually L side bc it works harder:
very tight and hard for blood to get through, dont open or close well, aortic -> stenosis
v lose and blood flows back with increased P, mitral: regugitation -> leaflets are floppy and lose

Question 3

aortic stenosis

Answer 3

blood cant flow freely from LV to aorta

Question 4

aortic stenosis: cm

Answer 4

usually asymp
syncope, light headed, chest pain
also SOB, pulm edema (back up) - crackles and ronchi, cough/congestion

Question 5

aortic stenosis: coronary vessels

Answer 5

give heart blood, dont get enough oxygenated blood
right next to junction where aorta leaves heart

Question 6

mitral regurgitation

Answer 6

LA - LV
usually replace valves
dx with echo (TE or TTE)
fatigue d/t not enough O2 blood, SOB

Question 7

endocardial disease: infective endocarditis

Answer 7

valve infection, vegetations on valves -> dont allow valve to open and close effectively, can become septic emboli (PE)
tricuspid = 1st valve infected blood goes through
rf: prosthetic valve (prophyl abx), pacemaker, IVDA

Question 8

infective endocarditis: cm

Answer 8

fever, chills, anorexia, weight loss, myalgias, arthralgias, heart murmur
s of ischemia or infarction of extremities, spleen, kidney, bowel, brain - S of stroke d/t septic emboli

Question 9

infective endocarditis: septic emboli

Answer 9

can cause meningitis, seizure, encephalopathy, or abscesses
microorganisms travel to heart, adhere to damaged endothelial tissue, attract wbc and plt -> release cytokines and coag factors
coag cascade -> fibrin deposition and eventually vegetation
vegetations found on valve leaflets, fragments can embolize and cause infection or oschemia in remote tissues

Question 10

infective endocarditis: septic emboli - cm

Answer 10

can see on CT
petechiae (emboli in capillary)
splinter hemorrhage = linear streaks in nail beds
janeway lesions = non tender lesions on palms and soles
osler’s nodes = SQ nodules in pulp of fingertips
roth spots = oval retinal hemorrhages with pale centers

Question 11

infective endocarditis: IVD users

Answer 11

veins are portal of entry, flora of skin most commonly cause bacteremia
travel from peripheral vein to heart
septic emboli can enter lungs bc most often tricuspid affected 1st