Valvular heart disease

Question 1

Define valvular heart disease

Answer 1

characterized by damage to or defect in one of the four heart valves, the mitral, aortic, tricupsid, or pulmonary, leads to increased workload on the heart

Question 2

Heart murmur

Answer 2

turbulent blood flow between heart chambers, denoting valve dysfunction. It is an abormal noise

Question 3

Heart murmurs may be due to

Answer 3

valvular incompetence, valvular regurgitations/insufficiency, valvular stenosis, valvular prolapse

Question 4

Valvular incompetence

Answer 4

valve is not functioning properly, non specific term

Question 5

Valvular regurgitations/insufficiency

Answer 5

a non specific term meaning the valve is unable to close properly, resulting in back flow. Atria are not empty as a new cycle begins

Question 6

Valvular stenosis

Answer 6

inability of the valve to open properly, resulting in a reduced volume of blood exiting the chamber and considerable pressure in the exit chamber- the idea of narrowing

Question 7

Valvular prolapse

Answer 7

valves bulge upwards, which can cause a back flow of blood, only occurs to the mitral valve

Question 8

Valvular heart disease common causes are

Answer 8

Hypertension/ Chronic congestive heart failure, complications of myocardial infarction, rheumatic fever, endocarditis, congenital abnormality, radiation therapy for cancer

Question 9

Rhuematic fever

Answer 9

an autoimmune reaction secondary to infection by streptococcus bacteria
antibodies which have developed to fight the infection appear to sense a chemical similarily between the bacteria and heart tissue

Question 10

Signs and symptoms of heart murmur

Answer 10

initially fatigue, later on breathlessness and dyspnea

Question 11

Mention of heart murmur or any valvular disease on the case history should lead to the RMT establishing ______

Answer 11

CCHF, chronic congestive heart failure

Question 12

RMT considerations for valvular disease

Answer 12

Watch for signs of dyspenea (ie. difficult or painful breathing), and increased SYNS activity (hearts with valve problems do not typically adapt easily to increased cardiac output)
-watch for increases in BP post treatment

Question 13

Mitral valve prolapse some AKAs

Answer 13

floopy valve, barlows, click-murmur syndromes

Question 14

Two valve flaps of the mitral valve do not close smoothly or evenly, but insteas bulge (prolapse) upward into the left atrium. What is the clinical name for this?

Answer 14

Mitral valve prolapse

Question 15

The most common cause of mitral valve prolapse (MVP) is

Answer 15

abnormally stretchy or floppy valve leaflets (called myxomatous valve disease) and their supporting chordae tendonae causing parts of the valve flop or bulge back into the atrium
MVP doesnt always cause backflow/regurgitation

Question 16

When backflow occurs what happens to the heart

Answer 16

It can change the hearts size and raise pressure in the left atrium and lungs, also raises the risk of heart valve disease

Question 17

What phase is the heart in when a click sound can be heard

Answer 17

systole, which is the protrusion, leaking of blood back into the upper chambers- can also be heard as a murmur

Question 18

What are some risk factors for MVP

Answer 18

benign in isolation, if not in isolation- heritable connective tissue disorders (marfans syndrome), endocarditis, myocarditis, atherosclerosis ( hardening of the arteries), SLE LUPUS, muscular dystrophy,

Question 19

Signs and symptoms of MVP

Answer 19

2/3rds of people are asymptomatic.
Chest pain/palpatations, SOB, dizziness, syncope (fainting), panic and anxiety, neuro signs and symptoms into hands and feet

Question 20

Marfans syndrome

Answer 20

a genetic connective tissue disorder, specifically it affects the elastic fibers in the extracellular matrix

Question 21

This presentation is classified as what syndrome? a person who has a long and thin body with long fingers, jt hypermobility, spinal deformities pectus excavatum or pigeon chest, their eyes may be BL dislocation of the lens (weakness of the suspensory ligaments), myotopia (near sightedness), retinal detachment. CV: progressive dilation of the aortic valve ring. Mortality: 30-40 years old- surgery and medications to prolong life

Answer 21

Marfans syndrome

Question 22

Define edema

Answer 22

an increase in the amount of fluid in the interstitial space either beneath the skin or in an organ cavity, typically palpable. It can be local or generalized condition

Question 23

what are some common clinical causes of edema

Answer 23

increased capillary pressure/ blood pressure, decreased colloid osmotic/oncotic pressure, increased capillary permeability, obstruction of lymphatic flow

Question 24

Common causes of local edema

Answer 24

Inflammation, sitting or standing in one position for too long, impaired circulation from restrictive scarring, restrictive immobilization, thrombosis, impaired lymphatic function, localized allergic reaction, decreased muscle tone, decreased vascular tone (sympathetic nervous system impairment)

Question 25

Ascites edema

Answer 25

excess fluid in the peritoneal cavity

Question 26

Hydrothorax/pleural effusion

Answer 26

excess fluid in the pleural space/cavity

Question 27

Pulmonary edema

Answer 27

fluid accumulation in the tissue and air spaces of the lungs

Question 28

Pericardial effusion

Answer 28

excess fluid in the pericardial space

Question 29

Pitting

Answer 29

edema of the skin- extremity, when firmy pressed with a finger will maintain depression produced by that finger- turns into trophedema causing peripheral sensitization

Question 30

Non pitting edema

Answer 30

no indentation in skin left after pressure, can be caused by lymphedema as well as myxedema and lipedemia

Question 31

Dependent edema

Answer 31

edema in the part of the body lower than the heart

Question 32

Chronic venous insufficiency (CVI)

Answer 32

weakened or even damaged veins, venules can lead to pooling of fluid distally, when those veins become dysfunctional due to load or stress placed on them it will cause venous insufficiency and the accumulation of fluid distally

Question 33

Edema massage therapy considerations

Answer 33

Lymph drainage techniques, elevation of limbs, massage techniques- long term edema can lead to tissue impairments such as fibrosis, compression (stockings, sleeves), hydrotherapy modifications use caution with heat, contrast and duration