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Week 5 - Cardiology > Valvular heart disease > Flashcards

Valvular heart disease Flashcards

1
Q

What is the definition of a valve?

A

A device for controlling the passage of fluid through a pipe or duct, especially an automatic device allowing movement in one direction only

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2
Q

What are the 4 heart valve?

A
  • Pulmonary
  • Mitral
  • Tricuspid
  • Aortic
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3
Q

Which valve does blood pass through when it moves from the left atrium to the left ventricle?

A

mitral

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4
Q

Which valve does blood pass through when it moves from the left ventricle to the aorta?

A

Aortic

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5
Q

Which valve does blood pass through when it moves from the right atrium to the right ventricle?

A

Tricuspid

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6
Q

Which valve does blood pass through when it moves from the left ventricle to the pulmonary artery ?

A

Pulmonary

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7
Q

What are the semilunar valves?

A

Aortic and pulmonary

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8
Q

How do the semilunar valves work?

A

They are made up of cusps, blood flowing backwards fill up the pockets so they close

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9
Q

How does the naming of the aortic valve leaflets work?

A

Right, left and non coronary. Named depending on if there is a coronary artery originating from the valve pocket or not

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10
Q

What are the components of an atrioventricular valve?

A
  • Valve leaflets
  • Chordae tendinae
  • Papillary muscles
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11
Q

What pathology can affect the valve leaflets?

A
  • Calcification
  • Thickening
  • Degeneration
  • Infection
  • Prolapse
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12
Q

What pathology can affect the apparatus/annulus?

A
  • Annular dilation
  • Annular calcification
  • Apparatus tethering/thickening/rupture
  • Regional wall motion abnormality
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13
Q

What causes stenosis?

A

Pressure overload

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14
Q

What causes regurgitation?

A

Volume overload

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15
Q

What are the symptoms of acute rheumatic fever?

A

Painful joints, fever, rash

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16
Q

How does rheumatic fever predispose to valvular heart disease?

A
  • Antibody cross reactivity affects the connective tissue

* Cardiac injury is generated by recurrent inflammation and fibrinous repair and scarring

17
Q

What causes aortic stenosis?

A 
•Increased LV cavity pressure 
•Pressure overload due to left ventricular hypertrophy
•Due to: 
- thickening
- calcification 
- rheumatic valve disease 
- congenital
18
Q

What are the symptoms of aortic stenosis?

A
  • Shortness of breath
  • Presyncope
  • Syncope
  • Chest pain
  • Reduced exercise capacity
19
Q

What are the signs of aortic stenosis?

A
  • Ejection systolic murmur
  • Soft/quiet second heart sound
  • Narrowed pulse pressure
  • heaving apex beat
  • Signs of heart failure
20
Q

What are the causes of aortic regurgitation?

A
  • Volume overload
  • LV dilation
  • due to:
    •Degeneration
    •Rheumatic valve disease
    •Aortic root dilation
    •Systemic disease associated with marfans, Ehlers danlos, ankylosing spondylitis, SLE
    •Endocarditis
21
Q

What are the symptoms of aortic regurgitation?

A
  • Shortness of breath

* Reduced exercise capacity

22
Q

What are the signs of aortic regurgitation?

A
  • Early diastolic murmur
  • Increased pulse pressure
  • Collapsing pulse
  • Signs of heart failure
  • Eponymous signs: corrigans, Quinkes and De mussets
23
Q

What is Corrigan’s sign

A

Carotid pulsation

24
Q

What is Quinke’s sign?

A

Nail bed pulsation

25
Q

What is De Musset’s sign?

A

Head nodding

26
Q

What are the names of the leaflets of the mitral valve?

A

Anterior and posterior

27
Q

What are the causes of mitral regurgitation?

A
  • Can be multifactorial (leaflets, annulus and apparatus)
  • Volume overload of the LA/LV
  • LV and LA dilation
  • Pulmonary hypertension
  • Secondary right heart dilation
  • Atrial fibrillation
28
Q

What are the symptom of mitral regurgitation?

A
  • Shortness of breath
  • Palpitation
  • right heart failure symptoms
29
Q

What are the signs of mitral regurgitation?

A
  • Pansystolic murmur
  • Quiet first heart sound
  • Displaced apex beat
  • Signs of heart failure
30
Q

What are the causes of mitral stenosis?

A
  • Rheumatic heart disease
  • Pressure overload
  • Dilated left atrium
  • Atrial fibrillation
  • Pulmonary hypertension
  • Secondary right heart dilation
31
Q

What are the symptoms of mitral stenosis?

A
  • Shortness of breath
  • Palpitation
  • Chest pain
  • Haemoptysis
  • Right heart failure
32
Q

What are the signs of mitral stenosis?

A
  • Diastolic murmur
  • Quiet second heart sound
  • Heaving apex
  • Signs of heart failure
33
Q

How many leaflets do each of the right sided valve have?

A
  • Pulmonary has 3

* Tricuspid has 3

34
Q

How can you asses valvular heart disease?

A
  • History
  • Examination
  • Blood pressure
  • ECG
  • Echo
  • CT
  • MRI
  • Exercise tolerance test
  • CPET
  • Left heart catheterisation
  • Right heart catheterisation
35
Q

Compare the mechanical and tissue valve

A
  • Mechanical is usually recommended if younger but you will need anticoagulation for the rest of your life which is contra indicated if they do contact sport or want to get pregnant
  • Mechanical lasts around 10-20 years
  • Tissue valve lasts around 5-10 years
36
Q

What is the procedural intervention for valvular heart disease?

A
  • TAVI
  • Mitraclip
  • Valvuloplasty

Week 5 - Cardiology (8 decks)

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