Week 144 Aortic Stenosis Flashcards
Define Aortic stenosis.
Narrowing of aortic valve
Cover cardiac cycle, including sounds, valves, and various lettered stages.
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What causes aortic stenosis?
calcific degenration
bicuspid valve (usually)
Rheumatic
What is the consequence of Aortic stenosis?
Pressure < in L ventricle
LV dilation and LV failure as consequence.
Px with dyspnoea, syncope and angina type pain - what do you suspect?
LV Failure 2ndary to Aortic stenosis(?)
What is NYHA? How is is used?
New York heart association scale - assess heart failure
What is CCS classification?
Canadian cardiovascular society
How many units should a woman have per day?
2
What sound would you hear in aortic stenosis?
Ejection systolic
What sound would you hear in mitral regurgitation?
pan systolic murmur
What does an ejection diastolic murmur indicate (subtle)?
Aortic regurgitation
What does a very subtle pan diastolic murmur, which small “bumps” in sound just after 1st and 2nd heart sound indicate?
mitral stenosi
When looking at a cardiac echo what do you look for?
Size CS area of valves assess morphology continuity equation modified bernioulli equation (?)
What is the modified bernioulli equation?
?
What are lvels a, b, and c of evidence?
write these up
What are classes of recomendations? 1 11 11a 11b 111
write these up
What are the class 1 indications for AVR?
Symptomatic patients with severe AS (level of evidence: b)
Severe AS undergoing CABG (LOE:3)
Severe AS with other valve surgery (LOE:3)
One other - see slide from lecture monday 9am
Name 4 types of prosthesis?
Autograft
Allograft/Homograft
Xenograft/Bioprosthesis
Mechanical Prosthesis
What lifestyle factor affects warfarin (< INR)?
Alcohol
Amiodarone has a reaction/interaction with what common drug?
warfarin
What is vasculogenesis?
The appearance of blood vessels seemingly out of “nowhere”, as opposed to angiogenesis (formation via branching of existing vessels)
Hemangioblasts form what?
Cells of the blood vessels and vascular system - and blood!
In day 19, vasculogenesis forms blood ____ in the ____
islands
mesoderm
Why is angiogenesis an important area of current research
anti cancer meds
Which cavity eventually becomes the thorax?
Primitive pericardial cavity
Which 3 pairs of veins are in the primitive vascular system (day 28)?
Sup and inf cardinal veins
vitelline veins
which important event occurs between day 23-35 with regards to heart chambers?
Endocardial cushions meet and diverge atrioventricular tube x2
What does the septum primum do?
Starts to grow down toward endocardial cushions, to separate atriums.
What opens before the ostium primum closes? Why does this happen?
Ostium secondum. To prevent blood pumping to developing respiratory tissue.
What forms over the secondum? What happens in birth?
One way valve, when born closes as full vascular system being used. Foramen ovale remains in some adults.
What is the conotruncal ridge?
Forms in embryonic heart tube, separating it to pulmonary trunk and aorta, at about 6 weeks. cause spiralled division of vasculature, and also descends to combine with muscular portion of intraventricular septum, separating the ventricles, and attaching aorta to L side and P trunk to R side.
If neural crest cells do not descend in to the developing heart, you get what?
congenital heat defects
LOOK AT SYMBRYO ON BLACKBOARD FOR EXAM (LIKELY) QUESTIONS
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Where do the umbilical arteries form from?
They are anterior branches of the iliac arteries
What is the organ of gas exchange in the fetus and the newborn?
Fetus = placenta Newborn = lungs
In the fetus the lungs are not ____
functional
What is the organ of nutrition in the fetus and the newborn?
Fetus - placenta
Newborn - gut
In the fetus there is tonic ____ of the lungs to prevent blood flow
vasoconstriction of artieries
Blood enters right atrium from?
ivc
svc
?
Which organ is prioritised in the foetus?
The brain
The venous return from the HEART itself comes through the ____?
???? *** sinus
see lecture notes (second mon am lecture) for more
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The valve of the IVC is called the _____ valve.
Eustachian valve.
How does the ductus arteriosus close?
Pulmonary vascular resistance >, therefore blood (oxygenated) from aorta goes to pulmonary artery. In response to high oxygen conc, smooth muscle contracts, closing the ductus.
Ductus arteriosus is known as ____ in later life
ligamentum arteriosum.
Decrease in right atrial pressure closes the ______-
foramen ovale
learn and make cards for vestigial structrues slide
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What do you know about persistent pulmonary hypertension of the newborn?
failure of pulmonary vasconstriction at birth
Usually caused by prenatal fetal hypoxia
Right to left shunting across PDA and PFO
Cyanosis, acidosis, lower limb sats >, multiorgan failure, death if left.
