Valve Disease Flashcards
Atherogenic and genetic factors
Athero - inc BMP2, dec OPG, inc MMP
Genetic - NOTCH 1 mutation
Effects of aortic stensosi
LVH (concentric) LHF Secondary mitral insuff Inc LA pressure Afib and thrombus in LAA Bivent failure Coronary insuff
BAV
Predisposes to dilation of ascending TAA due to intrinsic medial aortopathy
Acute RF
Childhood
Rise in ASO
Polarthritis with rash, nodules and chorea
Pancarditis
Aschoff bodies
Signs of carditis
Murmur, cardiac enlargement, CHF, pericarditis
Subq nodules at joints
Erythemia marginatum in acute RF
Dx of acute RF
Major - caridtis, polyarthritis, chorea, erthemia marginatum, subq nodeus
Minor - fever, arthralgia, inc ESR or CRP, prolonged PR
Dx need strep plus 2 major or 1 minor 1 major
Dx of IE
Majhor - 2 separate cultures, ECHO, new valve regurg
Minor - predisposing condition or drug use Temp over 28C Vascular phenomena Immunological pheno Microbiologic evidecne
2 major, 1 minor and 3 major or 5 minor
Chronc RHD
Valve fibrosis and deformity
Stneosis and insuff
Mitral»>aortic»>tricuspind
Fishmouth orifice
MAC
Older women
ESRD with hypercalc
Asx leading to regurg or stenossi
Induces a LBBB
FMV
PVCs with palpitations Midsystolic click Progressive mitral regurg (late systolic) Bact endocarditis Sudden death Most isolated
Ebstein’s malformation
Of tricuspid vlave
Right o left shunt across PFO
Fuindger clubbing due to hypoxia
Subtype of endocarditis
RHD - no orgs
IE - colonies of virulent and non virulent
NBTE - no orgas
LSE - from lupus
Comps of IE
Mycotic aneurysm in renal artery
Splenic abscess
SKin rash (Oslers nodes and Janeway lesions)
Fatal cerebral he,morrhage from rupture of mycotic aneurysm