Valvular heart disease Flashcards
Name the heart valves and describe where they are.
Tricuspid valves: between RA and RV
Mitral (bicuspid): between LA and LV
Pulmonary valves: between RV and pulmonary artery
Aortic valve: between LV and aorta
Which heart valves are semi-lunar?
Pulmonary
Aortic
Which heart valves are atrioventricular?
Mitral (bicuspid)
Tricuspid
Which of the heart valves have 2 cusps?
Mitral
Which of the heart valves have 3 cusps?
Tricuspid
Pulmonary
Aortic
Which valves create the S1 heart sound?
What does the S1 sound like?
S1 = atrioventricular valves
‘lub’
Which valves create the S2 heart sound?
What does the S2 sound like?
S2 = semilunar valves
‘dub’
What is the purpose of the heart valves?
To prevent backflow
What is meant by valve stenosis?
Narrowing of the valve
The valve doesn’t open properly
What is meant by valve regurgitation?
A leaky heart valve
Blood leaks back to where it was just pumped from
Or blood leaks through when the valves are supposed to be shut
What is meant by an incompetent valve?
A regurgitant one
What is aortic stenosis?
Stenosis, narrowing, inability to shut properly
of the aortic valve
What problems occur as a result of aortic stenosis?
Not all the blood in the LV can leave and enter the aorta at each ventricular contraction
The body becomes starved of oxygenated blood
LV must generate higher pressure to get the blood through the valve to the aorta
This leads to LV hypertrophy
You also get ventricular arrythmias
What causes aortic valve stenosis?
Congenital:
- aortic stenosis
- having a bicuspid valve when it should be tricuspid
Aging:
- degenerative calcification
- rheumatic heart disease
How do patients with aortic stenosis present?
Syncope and dyspnoea on exertion
Angina
Sudden death due to V arrhythmias
What are the signs of aortic stenosis?
Slow rising carotid pulse (pulsus tardus)
Decreased pulse amplitude (pulsus parvus)
Systolic ejection murmur
Soft or absent 2nd heart secong
What is the prognosis like for people with aortic stenosis?
Not great at all!
Investigation of aortic stenosis.
Echo:
See LV hypertrophy & dilation
See a reduced ejection fraction
ECG:
Evidence of LV hypertrophy
Depressed ST segment
CXR:
Prominence of ascending aorta