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MD3001 Cardiology > Valvular Disease > Flashcards

Valvular Disease Flashcards

1
Q

Stenosis definition

A

narrowing of valve outlet caused by thickening of valve cusps/increased rigidity or scarring

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2
Q

Incompetence definition

A

(insufficency/regurgitation)

incomplete seal when valves close allowing blood to flow backwards

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3
Q

What valves are making the first heart sound?

A
  • mitral
  • tricuspid
  • systole
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4
Q

What valves are making the second heart sound?

A
  • aorta
  • pulmonary
  • diastole
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5
Q

What are the common causes of valve stenosis and incompetence?

A
  • congenital heart disease:
  • bicuspid valve
  • atresia
  • cardiomyopathy:
  • hypertrophic
  • dilated
  • acquired:
  • rheumatic fever
  • MI
  • age-related: idiopathic calcific stenosis
  • endocarditis
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6
Q

What are the risks of aortic stenosis?

A
  • LVH
  • syncope
  • sudden cardiac death
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7
Q

What causes aortic stenosis?

A
  • calcification of congenital bicuspid valve
  • senile calcific degeneration (calcification of leaflets, diallowing normal opening of cusps)
  • rheumatic fever
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8
Q

What are the clinical symptoms of aortic stenosis?

A
  • dyspnoea
  • angina
  • syncope
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9
Q

What are the causes of aortic incompetence?

A
  • infective endocarditis
  • rheumatic fever
  • Marfan’s Syndrome
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10
Q

What are the consequences of aortic regurgitation?

A
  • increases volume of blood to be pumped
  • increases work of heart
  • hypertrophy and failure
  • can occur with aortic stenosis
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11
Q

What are the causes of mitral incompetence?

A
  • cusp/chordae damage:
  • rheumatic heart disease: scarring/contraction
  • floppy valve and Marfan syndrome: stretch
  • infective endocarditis: perforation
  • papillary muscle/valve ring damage:
  • post MI
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12
Q

What are the risks of mitral valve incompetence?

A
  • pulmonary hypertension

- RVH

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13
Q

Describe the progression of mitral stenosis

A
  • restricted blood flow to left ventricle
  • AF
  • back pressure results in pulmonary hypertension
  • right heart failure
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14
Q

What is the definition of infective endocarditis?

A
  • infection of valve with formation of thrombotic vegetations (aggregations of fibrin and platelets)
  • virulence of organisms which caused the infection depends on the damage and severity of the clinical illness
  • classified as acute/sub-acute
  • bacteraemia common
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15
Q

What are the risk factors for infective endocarditis?

A
  • valve damage (post rheumatic fever)
  • bacteraemia (dental/catheterisation/IV drug abuse)
  • immunosuppression
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16
Q

Describe rheumatic fever

A
  • acute multisystem disease
  • affects heart (myocarditis/valvulitis/pericarditis), joints, connective tissue
  • 3 weeks post streptococcal infection
  • immune mediated infection
  • affects children
  • can be recurrent
  • chronic valve disease decades later
17
Q

Describe the local and systemic complications of infective endocarditis

A
  • splinter haemorrhages/clubbing in nails
  • anaemia
  • bronchopneumonia
  • myocarditis
18
Q

Acute native valve endocarditis

A
  • valves can be normal
  • aggressive
  • virulent organisms including S.aureus and group B streptococci
19
Q

Sub-acute native valve endocarditis

A
  • abnormal valves
  • can be painless but can deteriorate
  • virulent organisms include a-haemolytic streptococci, enterococci
20
Q

Prosthetic valve endocarditis

A
  • mitral more susceptible than aortic
  • early onset: S.aureus, gram negative bacilli, candida
  • late onset: staphylococci, a-haemolytic streptococci, enterococci
21
Q

Valve disease in IV drug users

A
  • majority have no underlying valvular abnormalities
  • half of cases is tricuspid vlave
  • S.aureus most common
22
Q

Treatment of infective endocarditis

A
  • treat strep infection with antibiotics
  • prophylactic cover for invasive procedures
  • replace damaged valves
  • if suspicion clinically:
  • imaging: echocardiography
  • blood culture
  • IV antibiotics

MD3001 Cardiology (56 decks)

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