Valvular Heart Disease

Question 1

What is the purpose of a heart valve?

Answer 1

Maintain forward flow of blood in the heart

Question 2

Where does the Pulmonary valve lie between?

Answer 2

Right ventricle and pulmonary artery

Question 3

Where does the Tricuspid valve lie between?

Answer 3

Right atrium and ventricle

Question 4

Where does the Mitral valve lie between?

Answer 4

Left atrium and ventricle

Question 5

Where does the Aortic valve lie between?

Answer 5

Left ventricle and aorta

Question 6

Where does the semilunar valve lie between?

Answer 6

Aortic and pulmonary valves

Question 7

Where does the atrioventricular valve lie between?

Answer 7

Atria to ventricle

Question 8

What is valvular regurgitation?

Answer 8

Valve not closing properly causing leakage in the previous chamber

Question 9

True or false. Left valvular side disease is more severe then right

Answer 9

True!

Question 10

True or false. You can’t have a stenosis and regurgitation in the same valve

Answer 10

False! Rheumatic heart disease consists of both

Question 11

What causes regurgitation?

Answer 11

• Typically, incompetence of chordae tendinae and tricuspid valve
• Other cause: increase in atrial or ventricle size which pulls on the tendinae and tricuspid valve

Question 12

What is Valvular stenosis?

Answer 12

A narrowing of the valve due to valve leaflets attaching to each other

Question 13

What does regurgitation result in (heart remodelling wise)?

Answer 13

hypertrophy of muscles (left side more affected)

Question 14

What does Valvular stenosis result in (heart remodelling wise)?

Answer 14

A reduction in blood flow results in an increase pressure in the vessel behind and hypertrophy of that chamber

Question 15

What causes Valvular stenosis?

Answer 15

Rhematic heart disease, genetics, hypertrophic cardiomyopathy, calcification from age, MI

Question 16

What can you observe in people with Valvular stenosis?

Answer 16

Increase systolic blood pressure and stroke volume, narrow pulse pressure, slow faint pulse

Question 17

What is mitral valve stenosis?

Answer 17

Narrowing of valve from left atrium to ventricle

Question 18

True or false, end diastolic volume is reduced in Mitral valve stenosis?

Answer 18

True! Due to impaired filling

Question 19

True or false, impaired diastolic volume will result in reduced systolic ventricular filling?

Answer 19

True! Due to a reduced afterload

Question 20

What is the cause of Mitral valve stenosis?

Answer 20

Rhematic fever

Question 21

How often should an echo stress test be done with an exercise physiologist?

Answer 21

1-2 times a year

Question 22

What are contraindications to exercise in this population?

Answer 22

Absolute - symptomatic severe aortic stenosis

Relative - moderate to severe aortic stenosis with uncertain relation to symptoms

Question 23

True or false, Atrial flutter is most common in this population?

Answer 23

False! Atrial fibrillation ;)

Question 24

What is the Frank-Sterlin law?

Answer 24

Relationship between stroke volume and EDV

-More EDV = the heart has stretched more

Question 25

If there is a lot of EDV, what happens to stroke volume and why?

Answer 25

It decreases because the heart is over stretched and not contracting well