Pathology - Valvular Heart Diseases

Front 1

failure of a valve to open completely

Back 1

stenosis

Front 2

insufficiency

Back 2

failure of valve to close completely

Front 3

regurgitation

Back 3

usually due to insufficiency

Front 4

functional regurgitation

Back 4

valvular incompetence not due to valve pathology but dilation of ventricle or valve root

Front 5

sounds produced by abnormalities of blood flow

Back 5

murmurs

Front 6

MCC of aortic valve stenosis:

Back 6

calcification

Front 7

MCC of AV insufficiency:

Back 7

dilitation of aorta

Front 8

MCC of mitral stenosis:

Back 8

rheumatic heart disease

Front 9

MCC of mitral insufficiency:

Back 9

myxomatous degeneration of mitral valve

Front 10

What kind of calcification is implicated in calcific valvular disease:

Back 10

dystrophic calcification

Front 11

Congenital Calcific aortic steonisis due to?

Back 11

60-70 yr olds with those born with bicuspid AV due to increased hemoodynamic stress

Front 12

How is the aortic valve modified in calcific stenoisis?

Back 12

calcified masses in cusps and bases. FREE EDGES a d no fusion of commisures

Front 13

What does AV stenosis cause?

Back 13

LV hypertrophy

Front 14

Complications of AV stenosis?

Back 14

angina, ischemia, CHF

Front 15

people most affected by mitral annular calcification?

Back 15

women > 60 yrs and in patients with myxomatous degeneration of mitral valve

Front 16

Complication of mitral annular calcification:

Back 16

sites for thrombi: stroke
nidus for infection
- if AV node affected, arrythmia

Front 17

Mitral valve prolaps affects:

Back 17

young women

Front 18

morphology of prolapsed mitral valve:

Back 18

hooded, enlarged, floppy mitral valve

Front 19

Why is mitral valve considered mysomatous?

Back 19

deposition of mucoid material

Front 20

What causes mitral valve prolaps?

Back 20

developmental defect in CT such as Marfan syndrome

Front 21

mid-systolic click with late systolic murmur:

Back 21

Mitral valve prolapse

Front 22

complications of mitral valve prolaps:

Back 22

- infective endocarditis/septic emboli
- mitral insufficiency and rupture of chordae tendinae
- thrombi=stroke
- arrthymia and death

Front 23

Rheumatic Fever:

Back 23

systemic disease due to cross reaction of strep A antigen.

Front 24

Most important consequene of RF:

Back 24

chronic valvular deformities to cause mitral stenosis

Front 25

Aschoff bodies:

Back 25

granulomatous lesion with T lymphocytes, plasma cells, Anitschkow cells, caterpillar cells

Front 26

Presentation of RF:

Back 26

pancarditis, Aschoff bodies, endocardium fibirinoid necross and verrucae

Front 27

Chronic rheumatic heart disease:

Back 27

thickening of valve leaftlets with commissural fusion; scarring of aschoff bodies

Front 28

Complications of chronic rheumatic heart disease:

Back 28

left atrial dilation and thrombus, pumonary congestion and eventual RV hypertrophy

Front 29

diagnosis of rheumatic fever?

Back 29

based upon jones criteria?

Front 30

What is Jones Criteria?

Back 30

Two major manifestations or one major and 2 minor manifestations (more nonspec)
to diagnose rheumatic fever.

Front 31

bacterial infection of heart valves:

Back 31

infective endocarditis

Front 32

acute infective endocarditis involves:

Back 32

a normal valve with highly virulent organism

Front 33

subactue infective endocarditis involves:

Back 33

deformed valves with less virulent organisms; protracted course requiring prolonged antibiotics

Front 34

Risk factors for infective endocarditis:

Back 34

underlying cardiac abormalities
- immunodeficiency
- causative organisms

Front 35

endocarditis causing bacteria found in native abnormal valves

Back 35

strep viridans

Front 36

endocarditis causing bateria found in health or deformed valve:

Back 36

S aureus

Front 37

Organisms implicated in infective endocarditis in IV users

Back 37

Staph aureus

Front 38

Acute endocarditis morphology:

Back 38

fibrosis, inflammation of valves

Front 39

Subacute endocarditis morphology:

Back 39

less valvular destruction with fibrosis and granulation tissue at base of vegetation

Front 40

aquired right heart endocarditis:

Back 40

IV drug abusers
- most common organism is S Aureus

Front 41

Staph epidermis

Back 41

major orgniasm in prostetic valve endocarditis

Front 42

Complications of infective endocarditis:

Back 42

valve insufficiency or stenosis, abcess or perforation, embolic complications, glomerulonephritis

Front 43

NBTE

Back 43

nonbacterial thrombotic endocarditis

Front 44

NBTE

Back 44

smaller, sterile vegetations along leaflet without inflammation

Front 45

Most common complication of NBTE:

Back 45

emboli and infarcts

Front 46

Causes of NBTE:

Back 46

mucin producing adenocarcinomas, hypercoagulable states, catheter trauma

Front 47

Whati s Libman Sacks Endocarditis?

Back 47

small sterile vegetation without blood components (doesn't look as infected) on BOTH SIDES of valve

Front 48

Why is the right heart not involved in carcinoid heart disease?

Back 48

MAO inactivation of serotonin and bradykinin in pulmonary vasculature

Front 49

Why must carcinoid syndrome mean extra-GI involvement?

Back 49

because liver MAO can inctivate serotonin and bradykinin

Front 50

Carcinoid syndrome seen in right heart?

Back 50

diet pills (phenfen) and drugs

Front 51

complications associated with mechanical prosthesis?

Back 51

thromboembolic complications due to foreign surface; also infective endocardititis

Front 52

complications associated with bioprosthesis?

Back 52

structural deterioration; 50% need replacement by 15 yrs;

less likely to have thrombosis because its animal tissue that moves more naturally

BUT also have rist of infective endocarditis.