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02. Cardiovascular System > Valvular Heart Disease - Pathophysiology, Presentation & Investigation > Flashcards

Valvular Heart Disease - Pathophysiology, Presentation & Investigation Flashcards

1
Q

What are some examples of valvular heart disease?

A

Mitral stenosis

Mitral regurgitation

Aortic stenosis

Aortic regurgitation

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2
Q

What is mitral stenosis?

A

Narrowing of the mitral valve opening that blocks blood from from the left atrium to the left ventricle

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3
Q

What is narrowing of the mitral valve opening that blocks blood flow from the left atrium to the left ventricle called?

A

Mitral stenosis

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4
Q

What is the aetiology and pathology of mitral stenosis?

A

Rheumatic heart disease

Congenital mitral stenosis

]Systemic lupus erythematosus

Rheumatoid artheritis

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5
Q

What is the pathophysiology of mitral stenosis?

A

Lef atrium pressure increases

Left ventricle pressures normal

Pulmonary venous and capillary pressures increased

Pulmonary vascular resistance increases

Right heart dilation

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6
Q

What is the clinical examination for mitral stenosis?

A

Dyspnoea

Haemoptysis

Systemic embolism

Infective endocarditis

Chest pain

Hoarseness

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7
Q

What is hoarseness?

A

Abnormal voice changes

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8
Q

What are abnormal voice changes called?

A

Hoarseness

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9
Q

What are clinical examination findings for mitral stenosis?

A

Mitral facies

Pulse normal

JVP prominant

Tapping apex beat and diastolic thrill

Right ventricle heave

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10
Q

What investigations are done for mitral stenosis?

A

ECG

Chest X-ray

Echocardiogram

Cardiac MRI

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11
Q

What can be seen in the ECG for mitral stenosis?

A

P wave > 0.12s

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12
Q

What can be seen in the chest X-ray for mitral stenosis?

A

Left atrium enlargement

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13
Q

What can be seen in the echocardiogram for mitral stenosis?

A

Thickening and scarring of the leaflets

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14
Q

What is the treatment for mitral stenosis?

A

Diuretics and restriction of Na intake

Anticoagulants

Valvotomy

Mitral valve replacement

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15
Q

What is a valvotomy?

A

Incisions to relieve valvular stenosis

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16
Q

What are incisions to relieve valvular stenosis called?

A

Valvotomy

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17
Q

What is mitral regurgitation?

A

Leakage of blood backward through the mitral valve each time the left vantricle contracts

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18
Q

What is leakage of blood backward through the mitral valve each time the left ventricle contracts called?

A

Mitral regurgitation

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19
Q

What is the aetiology and pathology of mitral regurgitation?

A

Rheumatic heart disease

Mitral valve prolapse

Infective endocarditis

Degenerative

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20
Q

What is pathophysiology of mitral regurgitation?

A

Changes preload, afterload and left ventricular contractility

Left ventricular compensation

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21
Q

What are the clinical manifestations of mitral regurgitation?

A

Breathlessness

Pulmonary oedema

Fatigue

Exhaustion

Right heart failure

Dyspnoea

Palpitations

22
Q

What are the examinations findings for mitral regurgitation?

A

Pulse normal or reduced in heart failure

JVP prominant if right heart failure present

Brisk and hyperdynamic apex beat

Right ventricle heave

23
Q

What investigations are done for mitral regurgitation?

A

ECG

Chest X-ray

Cardiac catheterisation

Echocardiogram

24
Q

What is seen in an ECG for mitral regurgitation?

A

P wave > 0.12s

25
Q

What is seen in a chest X-ray for mitral regurgitation?

A

Cardiomegaly

Left atrium enlargement

26
Q

What is cardiac catheterisation?

A

Invasive diagnostic procedure that provides important information about the structure and function of the heart, uses X-rays of the coronary arteries using coronary angiography

27
Q

What is seen in an echocardiogram for mitral regurgitation?

A

Left ventricle dimensions

28
Q

What is the treatment for mitral regurgitation?

A

Preload and afterload reduction using nitroprusside

Mitral valve repair

Mitral valve replacement

29
Q

What is aortic stenosis?

A

Narrowing of the aortic valve restricting blood flow from the left ventricle to the aorta

30
Q

What is narrowing of the aortic valve called?

A

Aortic stenosis

31
Q

What is the aetiology of aortic stenosis?

A

Degenerative

Rheumatic heart disease

Bicuspid aortic valve

32
Q

What is the pathophysiology of aortic stenosis?

A

Rheumatic cause - adhesion of the commissures and stiffening of the free cusp margins

Degenerative cause - linked to atherosclerosis, thickening and calcification of the cusps from the base to free margins

Increase left ventricular systolic pressure leading to left ventricle failure

33
Q

What are the manifestations of aortic stenosis?

A

Long asymptomatic phase

Chest pain (angina)

Syncope

Dizziness

Breathlessness on exertion

Heart failure

34
Q

What are the examination findings for aortic stenosis?

A

Pulse small volume and slowly rising

JVP prominent if right heart failure present

Low blood pressure

Vigorous and sustained apex beat

Right ventricle heave

35
Q

What investigations are done for aortic stenosis?

A

ECG

Chest X-ray

Cardiac catheterisation

Echocardiogram

Chest MRI

36
Q

What is seen in the ECG for aortic stenosis?

A

ST/T changes

37
Q

What is seen in the chest X-ray for aortic stenosis?

A

Calcification of aortic valve

38
Q

What is seen in the echocardiogram for aortic stenosis?

A

Demonstrates the aortic valves cusp mobility

Shows left ventricle function and hypertrophy

39
Q

What is the treatment for aortic stenosis?

A

Limited to those who develop heart failure

Aortic valve repair

Aortic valve replacement

40
Q

What is aortic regurgitation?

A

Leaking of the aortic valve that causes blood to flow from the aorta into the left ventricle during diastole

41
Q

What is leaking of the aortic valve called?

A

Aortic regurgitation

42
Q

What is the aetiology of aortic regurgitation?

A

Dilated aorta (Marfan’s, hypertension)

Leaflets (bicuspid aortic valve, rheumatic heart disease, endocarditis)

43
Q

What is the pathophysiology of aortic regurgitation?

A

Increase left ventricle systolic pressure

Left ventricle hypertrophy and dilation

Increase oxygen demand

Myocardial ischaemia

Left ventricle failure

44
Q

What are the clinical manifestations of aortic regurgitation?

A

Long assymptomatic phase

Exertional breathlessness

45
Q

What are examination findings for aortic regurgitation?

A

Pulse large volume and collapsing

Wide pulse pressure

Hyperdynamic, displaced apex beat

46
Q

What investigations are done for aortic regurgitation?

A

ECG

Chest X-ray

Cardiac catheterisation

Echocardiogram

Chest MRI

47
Q

What is seen in the ECG for aortic regurgitation?

A

ST/T changes

48
Q

What is seen in the chest X-ray for aortic regurgitation?

A

Cardiomegaly

49
Q

What is seen in the echocardiogram for aortic regurgitation?

A

Demonstrates aortic valve cusp anatomy (thickening, prolapsing, number of cusps etc)

Shows left ventricle function, dilation and hypertrophy

50
Q

What is the treatment for aortic regurgitation?

A

Vasodilator therapy

Aortic valve replacement

Aortic valve repair

02. Cardiovascular System (72 decks)

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