Valve Diseases Flashcards
What are systole valve lesions?
Aortic stenosis
Mitral regurgitation
Pulmonic stenosis
Tricuspid regurgitation
What are diastole valve lesions?
Tricuspid stenosis
Pulmonic regurgitation
Mitral stenosis
Aortic regurgitation
What results in Rheumatic heart disease and which valves are implicated?
regurgitation or stenosis
mitral valve always involved
aortic valve less involved
What happens in aortic stenosis?
stiff aortic valve –> LV increases pressure (more than aortic) –> increased afterload (bc resistance to flow)
–> there is large systolic pressure gradient btw LV and aorta (pressure stays the same here)
What are clinical festures of aortic stenosis?
- largely in elderly
- due to calcification/fibrosis of valve
- wear and tear disease (calcium depsit and collagen breakdown)
T or F: bicuspid aortic valve is more prone to injury overtime
T: usually earlier in 50s and 60s
What conditions are associated with bicuspid aortic valve?
marfan syndrome
turner syndrome
coarctation of the aorta
What is the classic triad of symptoms in aortic stenoisi?
- HF and pulmonary edema –> increased LVEDP due to increased afterload
- syncope –> failure to increase CO (during higher metabolic demand) due to increased afterload
- chest pain (angina) –> increased LVEDP –> less coronary blood flow
What kind of murmur is present with aortic stenosis?
systolic crescendo-decrescendo murmur
What is usallu treatment for AS?
Surgery
What happens in mitral stenosis?
stiff mitral valve –> LA pressure greater than LV in diastole (because of increased resistance and LVEDP is lower than normal because filling is impeded (ie. less volume less pressure)) –> decreased pre-load
MS is uaually associated with what?
rheumatic fever
What is the most common symptom in MS?
- dyspnea (bc increased LA pressures –> pulmonary congestion)
What kind of murmur is expected with MS?
diastolic rumble with opening snap
What other symptoms may occur in MS?
hemotypsis
atrial fibrilation
stroke (due to AF)
dysphagia/hoarseness (large LA compresses esophagus/recurrent laryngeal nerve)
What happens in aortic regurgitation?
blood leaks across valve –> increases preload and SV
chronic: increased afterload bc more stroke volume overtime make the aorta stiff and reduces compliance
–> blowing diastolic murmur
What are the causes of AR?
dilated aortic root (leaflets pull apart as a result of HTN; syphilis rare)
Bicuspid aortic valve
Endocarditis
Marfan/Turner Syndrome (increased dilated aortic root and bicuspid)
What is a classic finding of AR?
- wide pulse (bc leaking into LV causes low diastolic pressure and higher SV creates higher CO which raises LVESP)
What happens in mitral regurgitation?
blood leaks across mitral valve to LA –> increased LA volume –> increased preload and SV
decreased afterload bc blood can flow to LA and aorta
T or F: MR is usually secondary to other heart problems
T –> ischemia, LV dilatation (functional MR), hypertrophic cardiomyopathy
What is the most common cause of primary MR?
Mitral valve prolapse (ie. degenerative/myxomatous)
What are some causes of MR?
endocarditits, rheumatic heart disease, downs (cleft mitral valve, endocardial cushion defect)
What are symptoms of MR?
HF –> high LVEDP –> pulmonary edema
–> dyspnea, pitting edema
What kind of murmjur is in MR?
holosystolic murmur at apex –> systolic click
RH precipitates from what?
streptoccocal pharyngitis
Why is RH implicated in valve disease?
antobodies to bacterial M proteins crossreact in hearrt
What happens to LV as aresult of AS?
LV becomes stiff –> higher pressure for any given volume
–> increased LVEDP
T or F: supravalvular aortic stenosis mimics AS
True: seen in williams syndrome
