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Cardiology Week 5 > Valvular Heart Disease Pathology > Flashcards

Valvular Heart Disease Pathology Flashcards

1
Q

what is the central valve in the surgical view of the heart valves?

A

aortic valve

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2
Q

name the three portions of the anterior leaflet of the mitral valve

A

A1,A2,A3

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3
Q

name the three portions of the posterior leaflet of the mitral valve

A

P1, P2, P3

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4
Q

what is the most repairable portion of the mitral valve

A

P2 of the posterior leaflet

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5
Q

name the three cusps of the aortic valve

A

right coronary cusp, non coronary cusp, left coronary cusp

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6
Q

which of s3/4 gallop is normal in children and young adults

A

S3

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7
Q

what causes a rub sound?

A

rubbing together of visceral and parietal pericardial layers of the heart

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8
Q

what is the cause of a systolic ejection click?

A

high pitched sound of the aortic or pulmonic valve opening, occurs after S1

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9
Q

what is the cause of a systolic non ejection click?

A

high pitched sound of the closure of the mitral valve

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10
Q

what is the cause of a snap?

A

short high frequency sound after S2…due to sudden arrest of the opening of the mitral or tricuspid valves

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11
Q

is mitral regurg murmur diastolic or systolic?

A

systolic

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12
Q

is mitral stenosis murmor diastolic or systolic?

A

diastolic

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13
Q

is aortic stenosis murmur diastolic or systolic?

A

systolic

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14
Q

is aortic regurgitation murmur diastolic or systolic?

A

diastolic

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15
Q

what is the usual cause of a bicuspid aortic valve?

A

congenital anomaly

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16
Q

which two cusps of the aortic valve usually fuse to cause bicuspid aortic valve?

A

Left coronary and right coronary cusps

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17
Q

what is another issue you can have related to the aorta with a bicuspid aortic valve?

A

often have dilated ascending aorta…needs to be repaired at 4.5 cm compared to usual 5 cm

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18
Q

what is the usual cause of mitral valve prolapse?

A

valve collagen and elastic fibers fragment leading to gel like substance that is much more stretchy than the normal mitral valve

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19
Q

what is the degneration of tissue called in mitral valve prolapse?

A

myxomatous degeneration

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20
Q

clinically, what is mitral valve prolapse most often related to?

A

infective endocarditis

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21
Q

what is the treatment for mitral valve prolapse? what is treatment dependent on?

A

treatment decisions are made based on the extent of mitral regurgitation…if severe enough then you will repair or replace the mitral valve

22
Q

what is the causative agent of rhemuatic heart disease/

A

group a beta hemolytic strep

23
Q

after you have strep…what follows that leads to rheumatic heart disease?

A

acute rheumatic fever…systemic infection of heart joints NS and skin

24
Q

how many layers of the heart are affected in acute rheumatic fever?

A

endocardium myocardium pericardium

25
Q

what layer of the heart remains affected after acute rheumatic fever and what layrers resolve?

A

endocardium remains affected and myocardium and pericardium resolve

26
Q

explain the physiology behind rheumatic heart disease

A

antibodies are made against group A beta hemolytic strep and these antibodies cross react with heart tissues (type 2 immune response)

27
Q

what happens histologically in the myocardium with acute rheumatic fever?

A

granulomas appear in the myocardium

28
Q

what are the granulomas in the myocardium called with acute rheumatic fever?

A

aschoff bodies

29
Q

what is a unique cell type in the granulomas of the myocardium with acute rheumatic fever?

A

macrophages that look like owl eyes…anischkow cells

30
Q

following acute rheumatic fever…what process leads to chronic rheumatic heart disease?

A

repair and fibrosis of the valves

31
Q

what uniquely happens to valves in chronic rheumatic heart disease?

A

the cusps of the valve/leaflets often fuse together

32
Q

define how infective endocarditis occurs

A

usually bacterial infection of the endocardial tissue of the heart with a strong preference for mitral and aortic valves

33
Q

what organism usually causes acute bacterial endocarditis?

A

virulent organism like staph A

34
Q

what group of people are more susceptible to acute bacterial endocarditis

A

IV drug users

35
Q

what is the difference between acute and subacute bacterial endocarditis?

A

acute uses virulent organisms while subacute does not…subacute has longer progression of disease

36
Q

what type of organism is usually involved with subacute bacterial endocarditis

A

less virulent like strep viridans

37
Q

in acute bacterial endocarditis what is the status of the heart valve prior to infection? what about in subacute?

A

normal valve for acute and abnormal valve for subacute

38
Q

describe the pathophys steps in acute bacterial endocarditis…

A

normal valve with injury leads to thrombus..bacteremia of virulent pathogen then gets into thrombus and able to adhere and colonize…leads to acute inflammation and ultimately necrosis of the valve

39
Q

does acute or subacute bacterial endocarditis lead to necrosis of the valve?

A

acute!

40
Q

what is a common side effect associated with acute and subacute bacterial endocarditis? why?

A

emboli…infarcts and abscesses

because of the thrombus formation

41
Q

what is a vegetation? and what disease is it common in?

A

an infected clot…common in acute and subacute bacterial endocarditis

42
Q

name the culture negative organisms that can play role in infective endocarditis

A 
Haemophilus
Aggregatibacter
Cardiobacterium
Eikenella
Kingella
43
Q

what is the treatment of infective endocarditis?

A

prolonged IV and oral antibiotics and surgery to remove vegetation and or repair the valves

44
Q

what is the most common cause of acquired vascular disease in developed world?

A

calcified vascular disease

45
Q

what type of valve does calcified vascular disease commonly include?

A

usually the left heart valves…commonly a bicuspid aortic valve

46
Q

what are the clinical causes of calcified vascular disease?

A

can be aortic stenosis or mitral stenosis/regurg

47
Q

what is the treatment for calcified vascular disease?

A

valve replacement

48
Q

define NBTE

A

non bacterial thrombotic endocarditis

49
Q

what is the physiology of NBTE?

A

non bacterial thrombotic endocarditis leads to coagulation and vegetation around valves of the heart…usually aortic and mitral

50
Q

what is the pathophysiology of the carcinoid tumor?

A

neuroendocrine cells make abnormally large amounts of serotonin that induce fibrosis around heart valves

51
Q

which valves are usually affected by carcinoid tumor?

A

right side!! pulmonic and tricuspid

Cardiology Week 5 (10 decks)

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