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Human Disease Y3 > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

describe the cardiac valves

A

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

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2
Q

what is cardiac valvular disease ?

A

functional deficiency of the valves

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3
Q

what are the 2 main types of valvular heart disease ?

A

valvular stenosis

valvular incompetence

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4
Q

what is valvular stenosis ?

A

narrowing of the valve orifice limits the quantity of blood passing through the valve

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5
Q

what is valvular incompetence ?

A

failure of the non-return function of the valve leads to valvular regurgitation

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6
Q

what are the consequences of valvular heart disease ?

A

reduction in cardiac output

infection

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7
Q

what results form a reduction in cardiac output ?

A

poor function, exercise intolerance, left ventricular hypertrophy, left ventricular failure, sudden death

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8
Q

what can result from infection ?

A

infective endocarditis

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9
Q

what is involved in left heart valvular disease ?

A

mitral stenosis,
mitral regurgitation,
aortic stenosis,
aortic regurgitation

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10
Q

what is mitral stenosis ?

A

thickening of the valve leaflets with calcification and closure of the commisures

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11
Q

what is mitral regurgitation ?

A

mitral valve prolapse –> bacterial endocarditis, rheumatic heart disease, IHD resulting in rupture of papillary muscle/chordae tendinae, cardiomyopathy

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12
Q

what is aortic stenosis ?

A

obstruction to the left ventricular flow,
degenerative calcification,
rheumatic heart disease

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13
Q

what is aortic regurgitation ?

A

arises from valve dysfunction or incompetence or dilation of the aortic root

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14
Q

what are the causes of aortic regurgitation ?

A 
rheumatic heart disease,
hypertension,
syphilis,
marfan's syndrome,
ehler's danlos syndrome,
osteogenesis imperfecta,
idiopathic aortic root dilation,
endocarditis
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15
Q

what are the complications of left heart valvular disease ?

A

heart failure,
atrial fibrillation,
endocarditis

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16
Q

what is involved in right heart valvular disease ?

A

tricuspid stenosis,

tricuspid regurgitation

17
Q

what causes tricuspid stenosis ?

A

rheumatic heart disease

18
Q

what causes tricuspid regurgitation ?

A

right ventricular enlargement caused by RHD, congenital HD or endocarditis secondary to IV drug use

19
Q

what causes rheumatic heart disease ?

A

acute rheumatic fever from group A streptococcal infection

20
Q

what are the complications associated with rheumatic heart disease related to ?

A

antibody cross reactivity

21
Q

what are the general complications of rheumatic heart disease ?

A

heart - pericarditis, myocarditis, endocarditis
joints - fitting polyarthritis
skin - subcutaneous nodules and skin rashes
arteries - arteritis

22
Q

what is the histological hallmark of rheumatic fever ?

A

The Aschoff Body -
swollen eosinophilic collagen
macrophages
lymphocytes

23
Q

what are the outcomes of rheumatic fever ?

A

most children never recover fully

scarring process thickens the valve cusps and fuses the commisures leading to stenosis of the valve

24
Q

what is infective endocarditis ?

A

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

25
Q

what is infective endocarditis classified into ?

A

acute - destructive, previously normal heart valve with highly virulent organism (S. aureus)
subacute - infection of previously abnormal valve with organisms of low virulence (S. viridians)

26
Q

what are the sources of organisms for infective endocarditis ?

A

oropharynx - streptococci
respiratory tract
skin - staphylococci, yeasts
GI an urinary tract

27
Q

what is the clinical presentation of infective endocarditis ?

A

cardiac disease
infection
embolism
immunological phenomena

28
Q

where do most cases of infective endocarditis occur ?

A

left sided valves mitral and aortic

29
Q

what is the pathogenesis of infective endocarditis ?

A

endocardial injury
adherence of platelets and fibrin
vegetation formation
secondary infection by microorganisms circulating the blood

30
Q

what medications might patients be taking for valvular heart disease and what are their relevance to dentistry ?

A

anticoagulants - bleeding risk
calcium channel blockers - gingival hyperplasia
beta blockers, ACE inhibitors, diuretics - oral drug reactions

Human Disease Y3 (24 decks)

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