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MD3001 - Cardiology Disease and Pathology > Valvular Disease; infective endocarditis > Flashcards

Valvular Disease; infective endocarditis Flashcards

1
Q

What is the function of a valve?

A

To allow forward flow of blood but prevent back-flow

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2
Q

What are the 4 components of valves?

A
  • Valve ring
  • Cusp
  • Chordae tendinea
  • Papillary muscle (mitral and tricuspid only)
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3
Q

What is vegetation?

A

Damage to the covering of valves forming thrombi; this results in the valve becoming calcified and not closing properly

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4
Q

What does valvular heart disease describe?

A

Any part of the valve is dysfunctional

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5
Q

Give 4 examples of functional failure in valves

A
  • Mitral stenosis
  • Mitral incompetence
  • Aortic stenosis
  • Aortic incompetence
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6
Q

What is stenosis?

A

Narrowing of the valve outlet caused by thickening of valve cusps, or increased rigidity or scarring

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7
Q

What is incompetence or insufficiency

A

Regurgitation is caused by an incompetent seal when valves close allowing blood to floe backwards

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8
Q

What is backflow of blood?

A

output is going in the wrong direction

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9
Q

The closing of what valves cause the first heart sound?

A

Mitral and tricuspid

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10
Q

The closing of what valves cause the second heart sound?

A

aortic and pulmonary valves

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11
Q

What are the common causes of valve stenosis and incompetence?

A
  • Congenital heart disease
  • Cardiomyopathy (hypertrophy)
  • Acquired:
    • Rheumatic fever
    • Myocardial infarction
    • age related - calcification
    • endocarditis
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12
Q

What is atresia?

A

absense or abnormal narrowing of an opening or passage in the body

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13
Q

Risks of aortic stenosis

A
  • Left ventricular hypertrophy
  • Syncope
  • Sudden cardiac death
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14
Q

Causes of aortic stenosis

A
  • Calcification of congenital bicuspid valve
  • Senile calcification degeneration
  • Rheumatic fever
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15
Q

Consequences of aortic stenosis

A
  • Increases the work of the heart
  • Ventricular hypertrophy (LHS)
  • Causes cardiac failure late in clinical course
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16
Q

Clinical symptoms of aortic stenosis

A
  • Dyspnoea
  • Angina
  • Syncioe
  • Orthopnea
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17
Q

Causes of aortic incompetence

A
  • Infective endocarditis
  • Rheumatic fever
  • Marfan’s syndrome
18
Q

What is Marfan’s Syndrome?

A

CT disorder; results in collagen deficiency and non-elastic skin

19
Q

What occurs in aortic regurgitation?

A
  • Increases the volume of blood to be pumped signficantly
  • Increases the work of the heart (CO)
  • Cardiac hypertrophy
  • Cardiac failure

**Can occur in the presence of aortic stenosis

20
Q

Causes of mitral incompetence

A
  • Cusp damage
    • Rheumatic heart disease
    • Floppy vakve and Marfan syndrome
    • Infective endocarditis
  • Chordaw tendinae
  • Papillary muscle
  • Valve ring
21
Q

Risks of mitral incompetence

A
  • Pulmonary hypertension
  • RV hypertrophy

**Almost always post-rheumatic fever

22
Q

When and where does mitral stenosis occur?

A
  • Congenital (rare)
  • Post rheumatic fever
    • Developing countries
23
Q

What does mitral stenosis restrict?

A

blood flow to LV

24
Q

What can mitral stenosis cause?

A
  • Atrial fibrillation
  • Back pressure results in pulmonary hypertension
  • Right heart failure
25
Q

What is infective endocarditis?

A

Infection of valve with formation of thrombotic vegetations (abnormal growth)

26
Q

What determines the damage and severity of endocarditis?

A

Virulence

27
Q

What is the most common type of endocarditis?

A

Bacteraemia

28
Q

What are the risk factors for infective endocarditis?

A
  • Valve damage
  • Bacteraemia
    • Dental
    • Catherisation
    • 10% unknown
    • IV drug abuse
  • Immunosuppression
29
Q

What is rheumatic fever?

A

Acute multisystem diseas affecting the heart, joints and CT

30
Q

When does rheumatic fever occur?

A

3 weeks post streoptococcal infection

31
Q

Is rheumatic fever immune mediated rather than direct infection

A

immune mediated

32
Q

Who does rheumatic fever occur in?

A

Children aged 4-16

33
Q

What is the long term effect of rheumatic fever?

A

Chronic valve disease

34
Q

What are the local and systemic complications of infective endocarditis?

A
  • Cerebral and retinal emboli
  • Myocarditis
  • Splenomegaly
  • Anaemia
  • Bronchopneumonia, pulmonary infarct (tricuspid endocarditis)
  • Renal infarcts, glomerulonephritis
  • Haematuria
  • Splinter haemorrahges
  • Clubbing
35
Q

What is acute native valve endocarditis?

A
  • Valves may be normal
  • Aggressive disease
  • Virulent organusms such as staph aureaus and group B streptococci
36
Q

What is a native valve?

A

A valve you are born with

37
Q

Subacute native valve endocarditis

A
  • Abnormal valves
  • Indolent but may deteriorate
  • Alpha-haemolytic streptococci, enterococci (urinary catheter)
38
Q

How to treat infective endocarditis?

A
  • Treat strep with antibiotics
  • Prophylatic cover for invasive procedures
  • Replace damaged valves
39
Q

What causes early onset endocarditis?

A
  • staph aureus
  • gram negative bacilli
  • candida species
40
Q

What causes late onset endocarditis?

A
  • straphylococci
  • alpha-haemolytic
  • streptococci
  • enterococci
41
Q

What valve is prosthetic valve endocarditis more likely in?

A

mitral is more likely than aortic

42
Q

What method should be used to administer antibiotics in endocarditis?

A

IV route

MD3001 - Cardiology Disease and Pathology (10 decks)

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