Valvular Heart Disease Flashcards
describe the cardiac valves
AV valves allow blood to flow from atria to ventricles -
tricuspid (right)
mitral (left)
pulmonary valve allows blood into pulmonary artery
aortic valve allows blood into aorta
what is cardiac valvular disease ?
functional deficiency of the valves
what are the 2 main types of valvular heart disease ?
valvular stenosis
valvular incompetence
what is valvular stenosis ?
narrowing of the valve orifice limits the quantity of blood passing through the valve
what is valvular incompetence ?
failure of the non-return function of the valve leads to valvular regurgitation
what are the consequences of valvular heart disease ?
reduction in cardiac output
infection
what results form a reduction in cardiac output ?
poor function, exercise intolerance, left ventricular hypertrophy, left ventricular failure, sudden death
what can result from infection ?
infective endocarditis
what is involved in left heart valvular disease ?
mitral stenosis,
mitral regurgitation,
aortic stenosis,
aortic regurgitation
what is mitral stenosis ?
thickening of the valve leaflets with calcification and closure of the commisures
what is mitral regurgitation ?
mitral valve prolapse –> bacterial endocarditis, rheumatic heart disease, IHD resulting in rupture of papillary muscle/chordae tendinae, cardiomyopathy
what is aortic stenosis ?
obstruction to the left ventricular flow,
degenerative calcification,
rheumatic heart disease
what is aortic regurgitation ?
arises from valve dysfunction or incompetence or dilation of the aortic root
what are the causes of aortic regurgitation ?
rheumatic heart disease, hypertension, syphilis, marfan's syndrome, ehler's danlos syndrome, osteogenesis imperfecta, idiopathic aortic root dilation, endocarditis
what are the complications of left heart valvular disease ?
heart failure,
atrial fibrillation,
endocarditis
what is involved in right heart valvular disease ?
tricuspid stenosis,
tricuspid regurgitation
what causes tricuspid stenosis ?
rheumatic heart disease
what causes tricuspid regurgitation ?
right ventricular enlargement caused by RHD, congenital HD or endocarditis secondary to IV drug use
what causes rheumatic heart disease ?
acute rheumatic fever from group A streptococcal infection
what are the complications associated with rheumatic heart disease related to ?
antibody cross reactivity
what are the general complications of rheumatic heart disease ?
heart - pericarditis, myocarditis, endocarditis
joints - fitting polyarthritis
skin - subcutaneous nodules and skin rashes
arteries - arteritis
what is the histological hallmark of rheumatic fever ?
The Aschoff Body -
swollen eosinophilic collagen
macrophages
lymphocytes
what are the outcomes of rheumatic fever ?
most children never recover fully
scarring process thickens the valve cusps and fuses the commisures leading to stenosis of the valve
what is infective endocarditis ?
acute/chronic disease resulting from infection of a focal area of the endocardium
heart valve usually involved but may involve the mural endocardium of the atrium or ventricle or a congenital defect
