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Cardiovascular System > Valvular disease > Flashcards

Valvular disease Flashcards

1
Q

Valvular disease is more common in which valves?

A

Aortic valve

Mitral valve

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2
Q

What is valve stenosis?

A

Valve doesn’t open enough

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3
Q

What is valve regurgitation?

A

Valve doesn’t close fully

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4
Q

What are the causes of aortic valve stenosis?

A

Degenerative fibrosis
Degenerative calcification

Chronic rheumatic fever

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5
Q

What causes degenerative fibrosis and calcification in aortic valve stenosis?

A

Valves face stress over time

become damaged

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6
Q

What predisposes to degenerative fibrosis and calcification of the aortic valve? Why?

A

Congenital bicuspid form of the valve

Because has two cusps instead of three
more stress per cusp
increased damage

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7
Q

How does chronic rheumatic fever cause valve stenosis?

A

Inflammation of valve,
fibrosis of valve,
cusps fuse together

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8
Q

What are the consequences of aortic valve stenosis?

A

LV hypertrophy

Left-sided heart failure

Microangiopathic haemolytic anaemia

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9
Q

How does aortic valve stenosis lead to LV hypertrophy?

A

Stenosed aortic valve increases resistance to blood flow out of LV
LV has to contract harder, generate more pressure to push blood through stenosed aortic valve

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10
Q

How does aortic valve stenosis lead to left-sided heart failure?

A

Stenosed aortic valve decreases blood flow out of LV

LV hypertrophy not maintained, LV wall thins, LV dilates

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11
Q

What are some of the symptoms of left-sided heart failure?

A

Angina

Syncope

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12
Q

What causes angina?

A

Decreased blood flow to myocardium

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13
Q

What causes syncope?

A

Decreased blood flow to CNS

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14
Q

How does aortic valve stenosis lead to microangiopathic haemolytic anaemia?

A

Red blood cells broken up as pass through stenosed aortic valve

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15
Q

What is the abnormal heart sound with aortic valve stenosis?

Why?

A

Crescendo-decrescendo murmur

louder and then quieter
by rapid ejection then reduced ejection giving
turbulent blood flow across stenosed aortic valve

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16
Q

What are the causes of mitral valve stenosis?

A

Chronic rheumatic fever

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17
Q

How does chronic rheumatic fever cause mitral valve stenosis?

A

Inflammation of valve,
fibrosis of valve,
cusps fuse together

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18
Q

What are the consequences of mitral valve stenosis?

A

LA dilation

Pulmonary hypertension

19
Q

How does mitral valve stenosis lead to LA dilation?

A

Stenosed mitral valve increases resistance to blood flow out of LA
less blood flow out of LA
increased blood volume and blood pressure in LA

20
Q

What are the consequences of LA dilation?

A

Atrial fibrillation

Oesophagus compression

20
Q

How does LA dilation lead to atrial fibrillation?

A

LA dilation stretches atrial myocytes

damages them

21
Q

What is the risk of atrial fibrillation? How?

A

Thrombus formation

due to stagnant pools of blood forming in the atria

22
Q

What is the symptom of oesophageal compression?

A

Dysphagia - difficulty swallowing

23
Q

How does mitral valve stenosis lead to pulmonary hypertension?

A

Blood backs up in the LA, pulmonary veins and pulmonary arteries
giving increased blood pressure in them

24
Q

What are the consequences of pulmonary hypertension?

A

Pulmonary oedema

RV hypertrophy

25
Q

What is the symptom of pulmonary oedema?

A

Dyspnoea - difficulty breathing

26
Q

How does pulmonary hypertension lead to RV hypertrophy?

A

RV has to contract harder to generate more pressure to push blood through the pulmonary circulation

27
Q

What is the abnormal heart sound with mitral valve stenosis? Why?

A

Snap as valve opens
Diastolic rumble

turbulent blood flow across stenosed mitral valve in diastole

28
Q

What are the causes of aortic valve regurgitation?

A

Aortic root dilation

Chronic rheumatic fever

28
Q

How does aortic root dilation cause aortic valve regurgitation?

A

Pulls valve cusps apart

29
Q

How does chronic rheumatic fever cause aortic valve regurgitation?

A

Inflammation of valve,
fibrosis of valve,
cusps don’t fit together

30
Q

What are the consequences of aortic valve regurgitation?

A

Bounding pulse

LV dilation

31
Q

What are the signs of a bounding pulse?

A

Head bobbing with each heartbeat

Quince’s sign - flushing of nails with each heartbeat

32
Q

How does aortic valve regurgitation cause a bounding pulse?

A

Blood flows back into LV from aorta in diastole
diastolic pressure decreases

Increased EDV leads to increased stroke volume in following systole
systolic pressure increases

33
Q

How does aortic valve regurgitation lead to LV dilation?

A

LV has increased EDV and EDP

becomes stretched

36
Q

What is the abnormal heart sound with aortic valve regurgitation? Why?

A

Early decrescendo diastolic murmur

turbulent blood flow across leaky aortic valve in diastole

37
Q

What are the causes of mitral valve regurgitation?

A

Myxomatous degeneration

Damage to papillary muscles after MI

Left-sided heart failure

Chronic rheumatic fever

38
Q

How does myxomatous degeneration lead to mitral valve regurgitation?

A

Weakens connective tissue, including chordae tendineae

valve prolapses

39
Q

How does left-sided heart failure lead to mitral valve regurgitation?

A

LV dilates

pulls apart valve cusps

40
Q

How does chronic rheumatic fever lead to mitral valve regurgitation?

A

Inflammation of valve,
fibrosis of valve,
cusps don’t fit together

41
Q

What is the consequence of mitral valve regurgitation?

A

LV hypertrophy

42
Q

How does mitral valve regurgitation lead to LV hypertrophy?

A

Backflow of blood from LV into LA in systole
means more blood fills the LV in diastole, higher EDV and EDP
becomes stretched

43
Q

What is the abnormal heart sound with mitral valve regurgitation? Why?

A

Holosystolic murmur

turbulent blood flow across leaky mitral valve in systole

Cardiovascular System (22 decks)

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