Pathophysiology I

Front 1

What is the Bicuspid Atrioventicular valve on the left side of the Heart called?

Back 1

Mitral Valve

Front 2

Name the leaflets of the Mitral Valve

Back 2

Anterior (anteromedial)

Posterior (posterolateral)

Front 3

The leaflets of the Mitral Valve connect to the Heart muscle through a ring called?

Back 3

Annulus

Front 4

Tendon-like chords, resembling parachute strings, that anchor the Mitral Valve to the Left Ventricle are called?

Back 4

Chordae Tendineae

Front 5

Which Mitral Valve leaflet attaches to a smaller portion of the circumference of the annulus?

Back 5

Anterior

Front 6

Which Mitral Valve leaflet is longer?

Back 6

Anterior

Front 7

Name the 3 segments of the posterior Mitral Valve leaflet.

Back 7

Lateral scallop

Central scallop

Medial scallop

Front 8

True/False:

The Anterior and Posterior Mitral Valve leaflets BOTH attach to the medial and lateral papillary muscles.

Back 8

TRUE

Front 9

True/False:

The Posterior Mitral Valve leaflet is the widest around the annulus.

Back 9

TRUE

Front 10

How should you obtain the Left Ventricular Inflow velocity?

Back 10

Pulse Wave at the Mitral Valve leaflets

Front 11

True/False:

Pulse Wave pattern will be solid.

Back 11

FALSE

Pulse wave pattern is hollow inside

Front 12

True/False:

Continuous Wave pattern is hollow inside.

Back 12

FALSE

Continuous wave pattern is solid and bright

Front 13

Mitral Valve Stenosis is a ____________ , _____________ and/or _______________ of the Mitral Valve.

Back 13

narrowing

thickening

obstruction

Front 14

Mitral Valve Stenosis impedes ____________ blood flow traveling from the Left Atrium, through the Mitral Valve, into the Left Ventricle.

Back 14

Diastolic blood flow

*because Mitral Valve is closed in systole

Front 15

A Mitral Stenosis murmur is a ________ pitched, __________ rumble with an opening snap.

Back 15

low pitched

diastolic rumble

Front 16

____________ disease predominantly affects the Mitral Valve and is almost always the cause of Mitral Stenosis.

Back 16

Rheumatic Disease

Front 17

What is the most common cause of Mitral Valve Stenosis?

Back 17

Rheumatic Disease

Front 18

What is a complication of a Strep throat infection that occurs between the ages of 5-15 years old that can damage the Mitral Valve called?

Back 18

Rheumatic Fever (disease)

Front 19

At a young age, Rheumatic fever can damage the Mitral Valve which can then lead to _____________ 20-30 years later.

Back 19

Mitral Valve Stenosis

Front 20

Which disease can cause doming of the Mitral Valve?

Back 20

Rheumatic Heart Disease

Front 21

Rheumatic Heart Disease can cause doming of the Mitral Valve during ____________?

Back 21

Diastole

Front 22

True/False:

People with Rheumatic Fever may have both Mitral Valve Stenosis and Regurgitation.

Back 22

TRUE

Front 23

What are 3 ways that Rheumatic Fever damages the Mitral Valve?

Back 23

1. thickening and scarring the leaflets
2. fusion of medial and lateral commissures
3. fusion/shortening/calcification/fibrosis(thickening/scarring) of the chordae tendineae
   

Front 24

Increased echogenicity seen in a pattern involving the entire Posterior Annulus is an indication of?

Back 24

Severe Mitral Annular Calcification (MAC)

Front 25

Mitral Regurgitation due to increased rigidity of the Mitral Annulus is called?

Back 25

Mitral Annular Calcification (MAC)

Front 26

What Interferes with the function of the Mitral Valve leaflets that is commonly found in elder patients?

Back 26

Mitral Annular Calcification (MAC)

Front 27

True/False:

Commissural fusion of the Mitral Valve leaflet tips is a cause of Mitral Annular Calcification (MAC).

Back 27

FALSE

Rheumatic Disease causes MV leaflet commissural fusion

Front 28

Term for the absence of a normal opening is?

Back 28

Atresia

Front 29

A Mitral Stenosis congenital anomaly where only one papillary muscle is attached to the Mitral Valve, is called?

Back 29

Mitral Valve Parachute

Front 30

A Left Atrial Tumor/Mass or Vegetation (due to Infective Endocarditits) that obstructs the Mitral Valve flow creates?

Back 30

Secondary Mitral Stenosis

Front 31

True/False:

Radiation treatment to the chest and some medications may cause Mitral Stenosis.

Back 31

TRUE

Front 32

What creates an obstruction to blood flow through the LVOT?

Back 32

Prosthetic Valve Dysfunction

Front 33

True/False:

In CW Doppler, the more shallow the Mitral Valve slope, the more severe the Stenosis.

Back 33

TRUE

Front 34

Mitral Stenosis causes pressure overload which can lead to?

Back 34

Hypertrophy

(wall thickening)

Front 35

Mitral Regurgitation causes volume overload which can lead to?

Back 35

Dilatation

Front 36

In Mitral Stenosis, increased LA pressure results in?

Back 36

Pulmonary Venous Hypertension

(high blood pressure)

Pulmonary Artery Hypertension

(high blood pressure)

Front 37

True/False:

Left Atrium thrombi are most common when Atrial Fibrillation is present but may occur in Sinus Rhythm.

Back 37

TRUE

Front 38

Left Atrium enlargement from Mitral Stenosis results in stasis of blood flow and the formation of?

Back 38

Thrombus

Front 39

Thrombi are preferentially located in the ________________ of the left Atrium, or can be protruding or laminated along the atrial wall or Interatrial Septum.

Back 39

Left Atrial Appendage

Front 40

What occurs when a thrombus, or portion of, breaks away traveling through the systemic circulation and becoming lodged within the circulatory system?

Back 40

Embolus

Front 41

Due to Left Atrial enlargement, thickened leaflets, and chordae tendinea prohibiting proper closure __________________ is common in patients with Mitral Stenosis.

Back 41

Mitral Regurgitation (co-existing)

Front 42

Due to Mitral Stenosis, the stretched and enlarged Left Atrium may lead to a heart rhythm irregularity causing the atria to beat chaotically and too quickly, which is called?

Back 42

Atrial Fibrillation

Front 43

True/False:

Mitral Stenosis can lead to Left Heart Failure.

Back 43

FALSE

MS can lead to RIGHT Heart Failure

Front 44

What are 3 indications of Mitral Stenosis in M-Mode?

Back 44

1. Thickened Mitral Valve Leaflets
2. Decreased E-F slope of the anterior MV leaflet
3. Anterior motion of the posterior MV leaflet
   

Front 45

The _______________ Method (equation) is used to measure Mitral Valve Area in the Cath Lab.

Back 45

Gorlin

Front 46

The time required for the peak gradient across the MV to reduce to one-half, which is quantitatively related to the degree of MS, is called?

Back 46

P 1/2 Time

Front 47

True/False:

The GREATER the P 1/2 Time, the more critical the MS.

Back 47

TRUE

Front 48

How is P 1/2 Time obtained?

Back 48

measure the deceleration slope from E to F on the MS waveform

Front 49

Mitral Stenosis Severity Scale (cm sqd.)

normal

mild

moderate

severe

Back 49

normal 4-6 cm sqd

mild 1.5 - 2.5 cm sqd

moderate 1.0 - 1.5 cm sqd

severe < 1.0 cm sqd

Front 50

Mitral Stenosis Severity ( P 1/2 Time ) scale

normal

mild

moderate

severe

Back 50

normal 30 - 60 msec
mild 90 - 150 msec
moderate 150 - 219 msec
severe > 220 msec

Front 51

Mean Pressure Gradient

Mild MS

Moderate MS

Severe MS

Back 51

Mild MS < 5 mmHg
Moderate MS 6 -10 mmHg
Severe MS > 10 mmHg

Front 52

What is Mitral Valve Prolapse also known as?

Back 52

Barlow's Syndrome

Front 53

Posterior displacement (beyond the MV annular plane) of any portion of the Mitral Valve leaflets, during Ventricular Systole is called?

Back 53

Mitral Valve Prolapse

(Barlow's Syndrome)

Front 54

Mid Systolic click with or w/out Systolic Murmur is caused by?

Back 54

Mitral Valve Prolapse

(Barlow's Syndrome)

Front 55

True/False:

Tricuspid Valve Prolapse is associated with Mitral Valve Prolapse.

Back 55

TRUE

(up to 50%)

Front 56

Which is the best view to evaluate a patient with Mitral Valve Prolapse?

Back 56

PLAX

Front 57

True/False:

DO NOT call an MVP a prolapse in an Apical View.

Back 57

TRUE

Front 58

In CW Doppler, the more ____________ the Mitral Valve slope, the more severe the Stenosis.

Back 58

Shallow

Front 59

In CW Doppler, the more shallow the Mitral Valve slope, the more ____________ the Stenosis.

Back 59

Severe

Front 60

Mitral Stenosis causes ______________ overload which can lead to Hypertrophy.

Back 60

Pressure overload

Front 61

___________________ causes volume overload which can lead to Dilatation?

Back 61

Mitral Regurgitation

Front 62

Mitral Regurgitation causes _____________ overload which can lead to Dilatation?

Back 62

Volume overload

Front 63

______________________ causes pressure overload which can lead to Hypertrophy.

Back 63

Mitral Stenosis

Front 64

Left Atrium thrombi are most common when _______________________ is present but may occur in Sinus Rhythm.

Back 64

Atrial Fibrillation

Front 65

Left Atrium enlargement from Mitral Stenosis results in _____________ of blood flow and the formation of thrombus.

Back 65

Stasis

Front 66

Enlargement of the ____________________ from Mitral Stenosis results in stasis of blood flow and the formation of thrombus?

Back 66

Left Atrium

Front 67

Atrial Fibrillation is caused by a stretched and enlarged Left Atrium due to what?

Back 67

Mitral Stenosis

Front 68

The degree of Mitral Stenosis can be measured by what?

Back 68

P 1/2 time

Front 69

Barlow's Syndrom is also known as?

Back 69

Mitral Valve Prolapse

Front 70

MItral Valve Prolapse is the posterior displacement of any portion of the Mitral Valve leaflets during ___________________?

Back 70

Ventricular Systole

Front 71

Which Mitral Valve leaflet is widest around the annulus?

Back 71

Posterior MV leaflet (posterolateral)

Front 72

Commissural fusion of the Mitral Valve leaflet tips is a cause by __________________.

Back 72

Rheumatic Disease

Front 73

The Mitral Valve is also known as the?

Back 73

Bicuspid AtrioVentricular Valve

Front 74

The leaflets of the ____________connect to the Heart muscle through a ring called the Annulus.

Back 74

Mitral Valve