Valvular Heart Disease Flashcards
What’s a stenotic valve?
Stenotic - where the valve doesn’t open properly and obstructs forward flow of blood
What does it mean when a valve is regurgitant/ incompetent?
The valve does not close properly resulting in backflow of blood into the chamber of origin
A change in function of a valve leads to a change in what
There will be change in the structure and function of the myocardium due to changes in workload
What happens to the left atrium when the mitral valve is affected
Increased work load for left atrium, leading to left atrial hypertrophy and dilation.
What happens to the left ventricle when the aortic valve is effected?
Increased work load to the left ventricle leads to hypertrophy of the myocardium
Which two valves are most commonly affected?
Mitral and aortic valve
Which valve pathologies are associated with ageing/wear and tear
Calcific aortic sclerosis (calcification leading to stenosis sclerosis), and calcification of the mitral valve annular ring
What valve pathologies acquired?
Rheumatic heart disease, bacterial endocarditis
What is a congenital valve disease
Bicuspid aortic valve disease
Which valve pathologies have an unknown cause?
Mitral valve prolapse with myxomatous degeneration of connective tissue of the valve
Describe calcific aortic sclerosis
It’s a disease that occurs in 7-9th decades. It occurs due to calcification of bone matrix proteins which then become ossified. This calcified material then fills and protrudes from the sinuses of the valsalva. the valve becomes rigid with resulting stenosis and some regurgitation (Commissures are not involved)
What are the two types of Rheumatic fever?
Acute and chronic rheumatic fever
Give a brief description of ARF
A systemic illness due to immune mediated damage to connective tissue. Cardiac involvement may be as endocarditis, myocarditis and pericarditis - pancarditis
Give a brief description of chronic RF
Results from changes in the heart valves due to ARF and consequent changes in the heart as a result of these abnormal values. Due to haemodynamics of blood flow through the heart the valve damage and the heart adaptations gradually worsen over time
When does ARF occur? and how does the valve damage occur?
Follows 2-3 weeks after a group A beta haemolytic streptococcal phayngitis
The Ab’s against streptococcal M protein produced in approx 3% individuals cross react with connective tissue and other antigens in various organs, especially the heart, joints and CNS.
CD4+ T cells specific for Strepococcoal peptides react with self antigens in the heart producing cytokines and activating macrophages. This damage is a combination of antibody and T cell mediated reactions
An inflammatory response follows
How can ACRF present clinically
What occurs when ARF causes endocarditis
What occurs when ARF causes pericarditis and myocarditis?
What are aschoff bodies?
How does the healing process lead to a shape change of the valve?
overview
In relation to the mitral valve, what does scarring of the endocardium lead to
Decribe the main effects that CRF causes
What is infective endocarditis, and how can it be classified
What are some features of acute bacterial endocarditis
Describe the pathogenesis of acute bacterial endocarditis
Describe subacute bacterial endocarditis
Describe the pathogenesis of subacture bacterial endocarditis
What are some complications of endocarditis
