Pathology Of Valvular Disease - Rush

Front 1

Significant disease of the valves in the ________ heart is rare and almost always congenital.

Back 1

Right

Front 2

The failure of a valve to open completely, leading to pressure overload.

Back 2

stenosis

Front 3

The failure of a valve to close completely, leading to volume overload.

Back 3

insufficiency/regurgitation

Front 4

Acute rheumatic heart disease affects what parts of the heart?

Back 4

-ALL - pancarditis (acute valve disease is not usually clinically significant, chronic is manifested as valvular disease)

Front 5

Describe the findings of valvulitis in acute RF

Back 5

-fibrinoid necrosis in foci along the valve leaflets
-overlying these areas are small vegetations along the lines of closure of left-sided valves
-called verrucous endocarditis

Front 6

Degenerated collagen surrounded by lymphocytes found in acute RF

Back 6

Aschoff bodies

Front 7

Activated macrophages with caterpillar-like nuclei surrounding degenerated collagen in acute RF

Back 7

Anitschkow cells

Front 8

Valve disease from chronic rheumatic fever typically presents at what age?

Back 8

30-50

Front 9

Chronic RF is the most common cause of _____________.

Back 9

mitral stenosis

Front 10

Describe the valve changes observed in mitral valve stenosis caused by chronic RF

Back 10

-thickened and retracted leaflets
-commissures fuse
-thickened and shortened chordae tendinae
-"fishmouth" or "buttonhole" appearance

Front 11

Chronic RF always involved the mitral valve, and may or may not involve what other valve?

Back 11

aortic

Front 12

The most common cause of aortic stenosis is ________________.

Back 12

degenerative calcification (usually presents age 65+)

Front 13

What congenital anomaly will make an individual more prone to calcific aortic stenosis?

Back 13

congenital bicuspid aortic valve

Front 14

In calcific aortic stenosis, calcified masses are primarily seen where?

Back 14

base of the leaflets

Front 15

What changes are seen when aortic stenosis is caused by chronic RF?

Back 15

fusion of the leaflets and calcification at the contact margins rather than at the base

Front 16

The ballooning up of the mitral valve into the left atrium shown here is called what?

Back 16

mitral valve prolapse

Front 17

What group is most commonly affected by mitral valve prolapse?

Back 17

young women

Front 18

T/F All prolapsed mitral valves are insufficient

Back 18

False

Front 19

Deposition of _____________ in place of collagen is seen microscopically in mitral valve prolapse.

Back 19

mucopolysaccharides (myxoid or myxomatous degeneration)

Front 20

2 other causes of mitral valve insufficiency

Back 20

-papillary muscle abnormality
-abnormal annulus

Front 21

Disease that can lead to fibrous annulus enlargement

Back 21

Marfan's disease

Front 22

What abnormal valve is shown dilated here as a result of Marfan's disease

Back 22

Aortic

Front 23

The most common primary tumor of the heart in adults

Back 23

cardiac myxoma

Front 24

T/F Cardiac myxoma is a malignant tumor

Back 24

F - benign

Front 25

Where is cardiac myxoma most commonly found

Back 25

left atrium

Front 26

Describe the tumor (gross)

Back 26

-almost always solitary
-up to 10 cm
-hard - gelatinous
-sessile or pedunculated

Front 27

Microscopically, cardiac myxoma is relatively hypocellular with an abundant ___________________ background.

Back 27

mucopolysaccharide

Front 28

T/F Prognosis for cardiac myxoma is very good.

Back 28

True (cured w surgery)

Front 29

T/F After surgical valve replacement, most patients have no complications.

Back 29

False - 60% have a problem

Front 30

Which kind of valve puts the patient at risk for thromboembolism and requires anticoagulant therapy?

Back 30

mechanical

Front 31

What are the disadvantages of bioprosthetic valves?

Back 31

They are subject to calcification and wear and tear over time