Week 3 Valvular Disease Flashcards
what are the AV valves
the tricuspid and the mitral valve
what is the tricuspid valve
between the right atrium and ventricle
what is the mitral valve
aka bicuspid. between the left atrium and ventricle
during diastole, which valves are closed
the pulmonary and aortic valves
during systole what valves are closed
the mitral and tricuspid
when do valves open
when contraction increases pressure within a give chamber greater than the downstream pressure.
when do valves close
when the pressure decreases below the downstream pressure.
what do the chordea tendinae and papillary muscles do
prevents the inversion of the valves, during ventricular systole
what happens with the chordea tendinae and papillary muscles are damaged from an MI
they can regurgitate and there can be back flow
what are the semilunar valves
aortic and pulmonary valves.
do the semilunar valves have chordea tendinae and papillary muscles
no!
what are some general symptoms of valvular disease
fatigue, dyspnea, palpitations, murmuring, chest pain, pitting edema, orthopnea and dizziness.
what is the most common type of valvular disease
aortic stenosis
how can bacteria on teeth affect the valves
the bacteria can affect the mitral valve.
what is the main cause of mitral stenosis
rheumatic heart disease, and autoimmune things.
what does stenosis to the mitral valve do
is increases the resistance to flow, and it doesn’t open as easily.
what happens int eh chamber upstream from the stenosis
there is hypertrophy
how can stenosis cause an arrhythmia
the atrium is stretched, and then there are multiple foci, which cause the arrhythmia.
why are people more at risk for a thrombus with a mitral stenosis
there is pooling and turbulent flow in the left atrium.
why might you have dyspnea with a mitral valve stenosis
the blood may pool and back up into the lungs.
what happens if you have mitral valve regurgitation or incompetence
you will get a valve that doesn’t close all the way during systole. This will create a back flow into the atria, and then the SV will have to increase to compensate for this diminished output. the atria will also get eccentric hypertrophy, which can lead to a dilated chamber.
what are signs and symptoms of mitral regurgitation and incompetence
anxiety and palpations with exercise.
what is a mitral valve prolapse
this is when the valve snaps open during systole, and you get a lot of regurgitation.
how might an MI lead to valve prolapse
if you have ischemia to the papillary muscles, you cannot maintain the cord tendinae, and you can get a prolapse.
what is aortic stenosis
thickening, calcification or both of the aortic valve without restricted motion. may even have a 2 leaflet valve (born that way)
what is aortic regurgitation and incompetence? causes?
the aortic valves can’t maintain their closure during diastole. may have congenital, rheumatic, endocarditis, Marfans, ankylosing spondy.
does aortic regurgitation or incompetence hurt pressure?
no became it is not changing the radius of the vessel. this is a condition in which the valve is spitting back.
can we rely on BP to determine how hard an exercise is for patients with valvular stenosis
no, must use RPE
what does impaired output mean for muscles
may have low perfusion
TF: patients with aortic stenosis are good candidates for exercise
false, the are not
how do we start exercise with someone with asymptomatic aortic stenosis
start at a low intensity and gradually build.
what is the difference between a mechanical and a biologic valve
mechanical lasts a lifetime, but need to be on anti clotting drugs all their lives. Biological last about 10 years.
who is a better candidate for a mechanical valve, age wise
a young kid.
mechanical valves are at higher risk for
infection, thrombus or emboli.
what is a minimally invasive option for a valve replacement
Da Vinci Robot. its a few small ports, and there is less risk of death, and you have a shorter LOS and less scar. But, you are on bypass longer, so the more of a risk for other things to go wrong.
what is a transcutaneous aortic valve repair/implantation (TAVI/R)
patients who are at higher risk for open heart surgery get this. you get a catheter in the femoral nerve and then to the aorta, which implants the new valve.
what are the layers of the pericardium
- fibrous outer layer that connects to the diaphragm and the mediastinum.
- a serous layer that lines the inner surface, (epicardium) and the fibrous layer (parietal)
between is the pericardial space, filed with fluid and lubricates the heart and decrease friction.
what can happen to the layers of the heart
you can get swelling, inflammation, infection. things like that
what is pericarditis
swelling and irritation of the pericardium
what can causes pericarditis
infections, bacterial, viral and fungal, and MI open heart surgery and radiation
what are the S/S of pericarditis
start pain with radiation to the back
fever
pain worse with deep breathing, coughing or laying flat
pain improved with sitting and leaning forward.
friction rub is heart on an auscultation.
what is pericardial effusion
accumulation of fluid in the pericardial space.
symptoms and signs of pericardial effusion
pressure in the chest, dysphagia, dyspnea, muffled heart sounds and JVD.
what can pericardial effusion progress to… and what is it
cardiac tamponade. the heart becomes compressed by that fluid, and the heart can’t pump, and fluid will go back into the lungs, so you die.
