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Week 5 - Cardiology > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

Name the 4 heart valves [4]

A
  1. aortic valve
  2. mitral valve
  3. pulmonary valve
  4. tricuspid valve
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2
Q

What are the features of the aortic valve? [3]

A
  1. semilunar valve
  2. lies between left ventricle and aorta
  3. has 3 cusps (tri-leaflet)
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3
Q

What are the features of the mitral valve? [3]

A
  1. bicuspid valve
  2. lies between the left atrium and left ventricle
  3. has 2 leaflets (anterior and posterior)
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4
Q

What are the features of the pulmonary valve? [3]

A
  1. 3 leaflets
  2. semilunar valve
  3. lies between right ventricle and pulmonary artery
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5
Q

What are the features of the tricuspid valve? [2]

A
  1. 3 leaflets
  2. lies between right atrium and right ventricle
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6
Q

Define the valve annulus [1]

A

the base of the heart valve that supports the leaflets

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7
Q

What structural defects can occur with the valve leaflets? [5]

A
  1. calcification
  2. thickening
  3. degeneration
  4. infection
  5. prolapse
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8
Q

What structural defects can occur with valve apparatus/annulus? [4]

A
  1. annular dilatation
  2. annular calcification
  3. apparatus tethering/thickening/rupture
  4. regional wall motion abnormality
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9
Q

Name the functional defects that can affect valves [2]

A
  1. stenosis
  2. regurgitation
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10
Q

Define stenosis [2]

A

abnormal narrowing of opening of heart valve resulting in pressure overload

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11
Q

Define regurgitation [2]

A

blood surging back through a defective valve in the heart after the heart has contracting resulting in volume overload

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12
Q

What is the cause of rheumatic valve disease? [1]

A

acute rheumatic fever

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13
Q

What is the cause of acute rheumatic fever and how does it progress? [2]

A
  • disease caused by strep. pyrogenes infection
  • may progress to chronic rheumatic valve disease, with cardiac injruy generated by recurrent inflammation, fibrinous repair and scarring
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14
Q

What are the typical symptoms of acute rheumatic fever? [3]

A
  1. painful joints (arthritis)
  2. fever
  3. rashes on skin
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15
Q

Which valve is most commonly affected by rheumatic valve disease? [1]

A

mitral valve

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16
Q

Define aortic stenosis [2]

A

narrowing of the opening of the aortic valve due to thickening or fusion of the cusps that comprise the valve

  • results in an obstruction of the flow of blood from the left ventricle to the aorta during systole
17
Q

What are the main causes of aortic stenosis? [3]

A
  1. rheumatic valve disease
  2. calcification
  3. may be congenital
18
Q

What are the complications of aortic stenosis? [2]

A
  1. Increased left ventricular cavity pressure
  2. Pressure overload leading left ventricular hypertrophy
19
Q

What are the typical symptoms of aortic stenosis? [5]

A
  1. Shortness of breath
  2. Presyncope
  3. Syncope
  4. Chest pain
  5. Reduced exercise capacity
20
Q

What are the typical signs of aortic stenosis? [5]

A
  1. Ejection systolic murmur
  2. Soft/quiet second heart sound
  3. Narrowed pulse pressure
  4. Heaving apex beat (due to left ventricular hypertrophy)
  5. Signs of heart failure
21
Q

Define aortic regurgitation [1]

A

A leak of the aortic valve resulting in reflux of blood from the aorta into the left ventricle during diastole

22
Q

What are the causes of aortic regurgitation? [8]

A
  1. Degenerative “wear and tear” of the aortic valve
  2. Rheumatic valve disease
  3. Aortic root dilatation
  4. Systemic disease
    • Marfan’s syndrome
    • Ehlers Danlos syndrome
    • Ankylosing spondylitis
    • Systemic lupus erythematosus (SLE)
  5. Endocarditis
23
Q

What are the complications of aortic regurgitation? [2]

A
  1. Volume overload
  2. Left ventricular dilatation
24
Q

What are the typical symptoms of aortic regurgitation? [2]

A
  1. Shortness of breath
  2. Reduced exercise capacity
25
Q

What are the typical signs of aortic regurgitation? [4]

A
  1. Early diastolic murmur
  2. Increased pulse pressure
  3. Collapsing pulse
  4. Signs of heart failure
26
Q

Define a bicuspid aortic valve abnormality [1]

A

Aortic valve that has 2 leaflets instead of the normal tricuspid leaflets (1-2%)

27
Q

What are the complications of a bicuspid aortic valve? [2]

A
  1. Prone to premature dysfunction
  2. Associated with aortic abnormalities
28
Q

Define mitral stenosis [1]

A

narrowing of the opening of the mitral valve

29
Q

What are the causes of mitral stenosis? [6]

A
  1. Rheumatic valve disease (most common cause)
  2. Pressure overload
  3. Dilated left atrium
  4. Atrial fibrillation
  5. Pulmonary hypertension
  6. Secondary right heart dilatation
30
Q

What are the typical symptoms of mitral stenosis? [5]

A
  1. Shortness of breath
  2. Palpitation
  3. Chest pain
  4. Haemoptysis - unique to mitral stenosis
  5. Right heart failure symptoms
31
Q

Define mitral regurgitation [1]

A

Failure of the mitral valve to close, allowing a reflux of blood from the left ventricle of the heart to the left atrium

32
Q

What are the causes of mitral regurgitation? [5]

A
  1. Multifactorial
    • Leaflets
    • Annulus
    • Apparatus
  2. Volume overload - left atrium/left ventricle
  3. LV and LA dilatation
  4. Secondary right heart dilatation
  5. Atrial fibrillation
33
Q

What are the typical symptoms of mitral regurgitation? [3]

A
  1. Shortness of breath
  2. Palpitation
  3. Right heart failure symptoms
34
Q

What are the typical signs of mitral regurgitation? [4]

A
  1. Pansystolic murmur
  2. Quiet first heart sound
  3. Displaced apex beat
  4. Signs of heart failure
35
Q

What types of investigations would you use for assessing valvular heart disease? [13]

A
  1. History
  2. Examination
  3. Blood pressure
  4. ECG
  5. Exercise Tolerance Test
  6. CPET (cardiopulmonary exercise testing)
  7. Stress echo
  8. Echo
  9. CT
  10. MRI
  11. Left heart catheterisation
  12. Right heart catheterisation
36
Q

What are the types of intervention used for valvular heart disease? [4]

A
  • Surgical:
    • valve replacement
  • Procedural:
    • TAVI (transcatheter aortic valve implantation)
    • mitraclip
    • valvuloplasty (Melody valve)

Week 5 - Cardiology (12 decks)

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