Valvular, Pericardial, and Congenital Heart diseases

Question 1

Valvular stenosis =

Answer 1

obstruction

Question 2

Valvular regurgitation =

Answer 2

incompetence

Question 3

how do cardiac chambers adapt to Valvular regurgitation?

Answer 3

eccentric hypertrophy

Question 4

how do cardiac chambers adapt to valvular stenosis?

Answer 4

concentric hypertrophy

Question 5

Aortic stenosis restricts the blood flow from –

Answer 5

the left ventricle to the aorta It may also affect the pressure in the left atrium

Question 6

causes of aortic stenosis

Answer 6

Post-inflammatory scarring (a.k.a. rheumatic valve disease)
Age-related calcific aortic stenosis
Congenital malformations (e.g. bicuspid AV)

Question 7

what is Aortic regurgitation ?

Answer 7

aortic valve doesn’t close tightly and some blood backflows

Question 8

causes of aortic regurgitation

Answer 8

Post-inflammatory scarring
Congenital malformations
Infective endocarditis
Aortic aneurysms
Collagen vascular diseases (e.g. Marfan syndrome)

Question 9

what is mitral stenosis?

Answer 9

narrowing of the mitral valve, doesn’t open properly, no blood flow to LV

Question 10

causes of mitral stenosis?

Answer 10

Post-inflammatory scarring (a.k.a. rheumatic heart disease)

Question 11

what is mitral regurgitation?

Answer 11

blood backflow through mitral valve every time LV contracts

Question 12

causes of mitral regurgitation?

Answer 12

• leaflet and commissural abnormalities (post-inflammatory scarring)
• abnormal tensor apparatus
• LV cavity and/or annular abnormalities

Question 13

post inflammatory scarring is a cause for –

Answer 13

mitral stenosis
mitral regurgitation
aortic stenosis
aortic regurgitation

Question 14

what is age-related calcific aortic stenosis?

Answer 14

Degenerative valvular disease due to progressive calcification and fibrosis

Question 15

gross findings of age-related calcific aortic stenosis?

Answer 15

• nodular calcification on outflow valve surface
• no commissural fusion
• usually normal mitral valve

Question 16

what is congenital bicuspid aortic valve?

Answer 16

two leaflets didn’t separate during dev in the womb

Question 17

prevalence of congenital bicuspid aortic valve?

Answer 17

1-2% of live births

Question 18

people with congenital bicuspid aortic valve are predisposed to –

Answer 18

progressive degenerative calcification

Question 19

When does calcific aortic stenosis occur in congenitally bicuspid aortic valves?

Answer 19

before 65

Question 20

what is acute rheumatic fever?

Answer 20

Immune-mediated, multisystem inflammatory disorder occurring 2-4 wks after group A streptococcal pharyngitis in about 3% of patients

Question 21

causes of RF?

Answer 21

pan-carditis

Question 22

what is the most important sequel of RF?

Answer 22

chronic valvular deformities, especially mitral stenosis (post-inflammatory scarring)

Question 23

gross findings for RF?

Answer 23

• Fibrinous pericarditis

- Small, irregular warty valvular vegetations

Question 24

what is the most distinctive lesion of RF?

Answer 24

Aschoff body

Question 25

where can Aschoff body be found?

Answer 25

pancarditis (all layers of heart)

Question 26

Describe Aschoff body

Answer 26

Foci of necrotic collagen surrounded by lymphocytes, plasma cells, & Anitschkow cells

Question 27

Describe Anitschkow cells

Answer 27

Plump macrophages with abundant cytoplasm, central round nuclei with central, slender, wavy chromatin