Valvular Heart Disease Flashcards
Which valves are the semilunar valves? How many cusps do they each have? What does their function/integrity depend on?
Aortic and Pulmonary Valves
3 cusps each
Function depends on integrity and coordinated movements of cusps and attachments
Which valves are the atrioventricular valves? How many cusps do they each have? What does their function/integrity depend on?
Tricuspid and Mitral
3 (tricuspid) and 2 (mitral)
Competency depends on leaflets + annulus, chordae tendinae, papillary muscles, ventricular wall
What is the valve leaflet core made of?
Collagen, elastin, ECM
What is the valve lined by on both the inflow and outflow tracts?
Endocardium
Bicuspid Aortic Valve
Describe what the problem is and what pathology it can lead to
Congenital disorder in which two cusps of the aortic valve have a midline raphe uniting them where they should normally be separated
Higher risk of developing aortic stenosis (in 50s or 60s) and infective endocarditis
May develops aortic dissections and aneurysms at higher rate
Valvular Degeneration due to Calcification
What causes it?
Normal “wear and tear” on the heart valves (there is some injury to the valves and they heal with fibrosis)
Atherosclerotic risk factors may also contribute to the development of this disease
Describe the problems caused by Calcific Aortic Stenosis
Calcified masses form on the aortic cusps, which prevent their opening, There is outflow obstruction and therefore an increased pressure gradient across the valve. Leads to concentric LV hypertrophy
Mitral Valve Prolapse is AKA…
Myxomatous Degeneration of Mitral Valves
Mitral Valve Prolapse
Describe the basic problem
Floppy, enlarged mitral valves leaflets balloon into the LA during systole
Can cause injury to the LA endothelium
What would you see on histology of mitral valve prolapse?
Deposition of extracellular mucus (myxomatous deposition within the valve tissue core)
What genetic disorder could lead to a greater risk of mitral valve prolapse?
Marfan’s Syndrome (fibrillin defect)
What would you hear on auscultation in mitral valve prolapse?
Midsystolic click from the valves ballooning into the atria during systole
Who most commonly is diagnosed with mitral valve prolapse? What do they normally present with?
Young women, commonly asymptomatic with no long term complications
Some have nonspecific symptoms (chest pain, dyspnea, fatigue)
What are some serious complications of mitral valve prolapse?
Infective endocarditis Mitral insufficiency Stroke/systemic infarct Embolism of a valve leaflet Arrhythmias
What is infective endocarditis? What is the characteristic finding?
Destructive inflammation of cardiac valves and endocardium, commonly due to bacterial infection
Vegetations growing on valve leaflets are common