Valvular heart disease Flashcards
What is stenosis and what problem does it cause?
Heart valves become rigid, they do not allow sufficient flow and cause high blood pressure
What is regurgitation or insufficiency?
The valves are floppy and allow backflow
What can happen if the rate of development for valvular heart disease is slow?
The heart can compensate by increasing the size of the left ventricle and the vasculature that accompanies it
On what side do most valve diseases occur?
The left side
What is the most common of all valvular abnormalities?
Calcific aortic stenosis
At what age does it occur?
Usually around 70-90 but can occur between 50-70 if there is a congenital defect
What is a genetic defect of valves that we discussed?
Bicuspid aortic valves
Abnormalities of what structure frequently accompany bicuspid aortic valve? What is a major site of calcific deposits?
Aortic wall, the raphe
What type of degeneration is seen in calcific aortic stenosis and what accumulates causing the calcification?
Wear and tear, see a buildup of calcium salt hydroxyapatite
What is the end result of calcific aortic stenosis?
There is a narrowing of the aortic valve and the heart works harder causing concentric ventricular hypertrophy. Over time the heart becomes ischemic because there is insufficient vasculature to support the tissue
What is mitral valve prolapse?
Mitral valve leaflets are floppy and prolapse into the atrium during systole
What will be heard during the heart beat in mitral valve prolapse?
A mid-systolic click
What is myxomatous?
When connective tissue is irritated and makes a mucoid fluid
Grossly, what will you see in mitral valve prolapse?
The valve ballooning into the atrium, also known as hooding
What will be seen microscopically?
Thickening of the spongiosa layer and deposition of mucoid material
What disorders and gene defects is mitral valve prolapse associated with?
Marfan syndrome and defects in FBN-1
Those defects lead to excess?
TGF-beta
Rheumatic fever occurs following?
Infection by streptococcal pharyngitis or strep throat
During the active phase of rheumatic fever, people get?
Acute rheumatic carditis
Rheumatic fever is the most common cause of?
Mitral valve stenosis
What type of plaque forms in response to rheumatic fever? These are caused by?
MacCallum’s plaques, caused by regurgitant jets of blood flow in the mural endocardium
What will be present histologically in the heart following rheumatic fever?
Caterpillar cells and Aschoff bodies
Which valve is usually involved with chronic rheumatic heart disease?
Mitral valve
Severe mitral stenosis is a result of?
Rheumatic heart disease
What are the results of mitral stenosis?
The left atrium dilates and there may be formation of a mural thrombi which can embolize
What bacteria usually causes acute endocarditis? What hearts does it affect and describe the course of the illness.
Staph aureus, can affect all hearts and this usually occurs rapidly
What bacteria usually causes subacute bacterial endocarditis? Describe the course. What hearts does it affect?
Strep viridians. Affects deformed hearts, more protracted course than acute
What bacteria typically cause prosthetic valve endocarditis?
Coagulase negative staphylococci
What is marantic endocarditis?
A form of nonbacterial thrombotic endocarditis
Who gets nonbacterial thrombotic endocarditis?
Those who are debilitated and in a hyper coagulable state
What happens in Trosseau’s Syndrome?
A patient has spontaneous thrombi
Libman Sacks endocarditis is seen in those with what disease?
Lupus
Libman Sacks endocarditis has the presence of what microscopically?
Hematoxylin bodies
