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B2. 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
What is seen in a chest X-ray for mitral regurgitation?
Cardiomegaly Left atrium enlargement
26
What is cardiac catheterisation?
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
What is seen in an echocardiogram for mitral regurgitation?
Left ventricle dimensions
28
What is the treatment for mitral regurgitation?
Preload and afterload reduction using nitroprusside Mitral valve repair Mitral valve replacement
29
What is aortic stenosis?
Narrowing of the aortic valve restricting blood flow from the left ventricle to the aorta
30
What is narrowing of the aortic valve called?
Aortic stenosis
31
What is the aetiology of aortic stenosis?
Degenerative Rheumatic heart disease Bicuspid aortic valve
32
What is the pathophysiology of aortic stenosis?
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
What are the manifestations of aortic stenosis?
Long asymptomatic phase Chest pain (angina) Syncope Dizziness Breathlessness on exertion Heart failure
34
What are the examination findings for aortic stenosis?
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
What investigations are done for aortic stenosis?
ECG Chest X-ray Cardiac catheterisation Echocardiogram Chest MRI
36
What is seen in the ECG for aortic stenosis?
ST/T changes
37
What is seen in the chest X-ray for aortic stenosis?
Calcification of aortic valve
38
What is seen in the echocardiogram for aortic stenosis?
Demonstrates the aortic valves cusp mobility Shows left ventricle function and hypertrophy
39
What is the treatment for aortic stenosis?
Limited to those who develop heart failure Aortic valve repair Aortic valve replacement
40
What is aortic regurgitation?
Leaking of the aortic valve that causes blood to flow from the aorta into the left ventricle during diastole
41
What is leaking of the aortic valve called?
Aortic regurgitation
42
What is the aetiology of aortic regurgitation?
Dilated aorta (Marfan's, hypertension) Leaflets (bicuspid aortic valve, rheumatic heart disease, endocarditis)
43
What is the pathophysiology of aortic regurgitation?
Increase left ventricle systolic pressure Left ventricle hypertrophy and dilation Increase oxygen demand Myocardial ischaemia Left ventricle failure
44
What are the clinical manifestations of aortic regurgitation?
Long assymptomatic phase Exertional breathlessness
45
What are examination findings for aortic regurgitation?
Pulse large volume and collapsing Wide pulse pressure Hyperdynamic, displaced apex beat
46
What investigations are done for aortic regurgitation?
ECG Chest X-ray Cardiac catheterisation Echocardiogram Chest MRI
47
What is seen in the ECG for aortic regurgitation?
ST/T changes
48
What is seen in the chest X-ray for aortic regurgitation?
Cardiomegaly
49
What is seen in the echocardiogram for aortic regurgitation?
Demonstrates aortic valve cusp anatomy (thickening, prolapsing, number of cusps etc) Shows left ventricle function, dilation and hypertrophy
50
What is the treatment for aortic regurgitation?
Vasodilator therapy Aortic valve replacement Aortic valve repair

B2. Cardiovascular System (41 decks)

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