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6 Cards in this Set

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Define Key Words pertaining to Heart Disease
Do it
Describe typical X-ray findings associated with stenosis or insufficiency of the mitral or aortic valve.
Aortic stenosis: large left ventricle (both LV hypertrophy and Left atrial enlargement), calcification of aortic valve, large ascending aorta

Aortic regurgitation: Large left ventricle, very large ascending aorta, pulmonary congestion

Mitral stenosis: large left atria, pulmonary congestion, calcified mitral valve?

Mitral insufficiency: asymmetric pulmonary edema (mostly on the right side), LV enlargement, LV prominencellll
Describe Doppler echocardiography and how it is used to diagnose cardiac valvular lesions.
Sound waves are bounced off fluids. When the fluid is moving against the direction of the sound waves, high frequency waves are bounced back, which are depicted blue. Flow that is moving in the opposite direction will be red.

By doing this, we can determine if fluid is moving in the correct direction.
Discuss the pathophysiology and clinical consequences of each of the four valve disorders and describe the structural basis for each.
Aortic stenosis:
hypertrophy of left ventricle --> angina, infarct, arrhythmia, sudden death
inability to increase CO --> syncope upon exertion, dyspnea
obstruction of LV ejection --> left ventricle failure
Turbulent flow leading to infection: infective endocarditis

Aortic insufficiency:
Left ventricular hypertrophy --> arrythmia, angina, sudden death, infarct
Chronic Increased EDV --> Left ventricular hypertrophy leading to congestive heart failure
Acute Increased LDV leading to increased atrial and capillary pressure --> pulmonary edema leading to dyspnea
Mitral stenosis:
Left atrial enlargement --> pulmonary congestion leading to dyspnea
Increased pulmonary pressure leading to increased bronchial venous pressure/rupture --> coughing blood (hemoptysis)
pulmonary venous hypertension leading to pulmonary arterial hypertension --> RV enlargement leading to right-sided failure
decreased CO: exercise intolerance
LA enlargement leading to fibrillation: thromboemboli leading to stroke

Mitral insufficiency:
Everything in mitral stenosis plus..
Turbulent flow over valve leading to infection --> infective endocarditis
Describe the valve pathology of each of the 4 valve disorders
Aortic stenosis: calcification of the leaflets --> due to age, decrease in leaflet number (normally three) which is congenital, or rheumatic fever

aortic insufficiency: all pathologies associated with stenosis plus aortic aneurysm or dissection and trauma
mitral stenosis: 99% of all cases due to rheumatic fever that calcifies leaflets and tendinous cords. Also valvulitis, endocarditis, and severe mitral calficiation due to age can be causes

mitral insufficiency: trauma, endocarditis, rheumatic fever, mitral valve prolapse, and degeneration over time
Describe conditions of the ascending aorta that could impair aortic valve function
trauma

reduced elastance: creates higher pressure in the aorta, leading to hypertrophy