Valvular Disease

Front 1

3 types of valvular disease

Back 1

1) stenosis - too tight - doesn't open enough
2) incompetency - too leaky - regurgitation
3) combination of stenosis + leaky = due to calcification

Front 2

causes of valvular disease

Back 2

1) congenital
2) acquired
(degenerative,
inflammation
neoplastic,
iatrogenic)

Front 3

2 inflammatory related reasons for valvular disease

Back 3

1) rheumatic fever (most common)
2) infective endocarditis

Front 4

infective endocarditis occurs in ____ % of valves that were previously damaged

Back 4

95-98%

Front 5

rheumatic disease --> valvular disease is the ___ cause of inflammatory related causes of VD. it is still v rampant in ____ countries (due to _____). ____ infection that is transmitted between family members

Back 5

leading cause
rampant in poorer countries due to poor living conditions
Strep infections

Front 6

rheumatic disease causes ____ damage to the myocardium (pericardium + ____), and ____ damage to the valves

Back 6

acute damage to the myocardium
permanent damage to the valves

Front 7

rheumatic disease
- now down to ___ %
- Acute_____inflammatory disease
- Involves ____ organ systems
Follows Group ____ Hemolytic _______
Pharyngitis (Approximately 3%)
Acute:_____Carditis

Back 7

down to 3%
- acute immune mediated inflammatory disease
- involvees multiple organ systems
- follows group A hemolytic streptococcal pharyngitis
- acute: rheumatic carditis

Front 8

rheumatic affects the valves in 3 ways

Back 8

1) The valve tissues become thick and do not move easily, 2) the junctions between two leaflets or three (whichever valve it is) fuse to each other
3) the orifice becomes narrow and narrower leading to stenosis

Front 9

rheumatic leads ___ scars on the myocardium

Back 9

focal scars

Front 10

mitral valve (bicuspid; left heart) stenosis can be:
a) acquired
b) congenital

Back 10

Acquired: Rheumatic,
Congenital: Rare
Cor triatriatum
Endocardial Bands

Front 11

the most common reason for aortic valve stenosis is:

Back 11

Degenerative (MOST COMMON REASON)

Front 12

mitral valve incompetence is due to:

Back 12

Rheumatic (with “fixed” stenosis)
Myxomatous change (“floppy”)
Annular dilatation
Annular calcification
Infective endocarditis

Front 13

other reasons for mitral valve dysfunction

Back 13

Myocardial Infarction (heart attack)
Post MI Pappillary muscle rupture
Rupture of Chordae tendinae
MV Annular dilatation

Front 14

treatment for infective endocarditis

Back 14

Treatment:
General /supportive
Antibiotics
Valve replacement

Front 15

low virulent infective endocarditis leads to ____

Back 15

subacute bacterial endocarditis

Front 16

highly virulent infective endocarditis leads to ___

Back 16

death within a few days to weeks

Front 17

major complication with mechanical heart valves?

Back 17

need lifelong anticoagulants,

Front 18

types of heart valves

Back 18

Bioprostheses or Tissue Valves
Porcine
Homograft
Pericardial
[Duramater]
Autografts

Front 19

end result of valvular disease

Back 19

heart failure (heart is weakened or damaged due to some underlying conditions and can't sufficiently pump blood to the rest of the body)

Front 20

treatments for heart failure

Back 20

Treat Underlying Disease
Treat the Heart Failure
Medical-Pharmacologic Therapy
Surgical: Valves
Transplant
Artificial Heart

Front 21

2 leading causes of heart failure

Back 21

MI
hypertension

Front 22

causes of heart failure

Back 22

Heart valves that are not working properly by being too narrow or leaky (heart valve disease)
Infection causing inflammation of the heart muscle (endocarditis or myocarditis)
Excessive use of alcohol or drugs
Diabetes
Being obese or overweight
High blood cholesterol
Heart muscle disease of unknown causes
Other medical conditions such as thyroid diseases or anemia.

Front 23

how does the heart compensate for congestive heart failure?

Back 23

1) making the chambers bigger
2) adding more muscle to the heart walls
3) beating faster

Front 24

drug therapy is a cornerstone for treatment of heart failures. some drugs include:

Back 24

Angiotensin converting enzyme (ACE) inhibitors
Angiotensin receptor blockers (ARB)
Beta-blockers
Aldosterone receptor antagonists (Mineralocorticoid receptor antagonist)
Diuretics (water pills)
Digoxin

Front 25

2 basic dysfunctions in heart failure

Back 25

1) systolic dysfunction occurs when the heart can't pump enough blood to supply all the body's needs

2) diastolic dysfunction occurs when the heart cannot accept all the blood being sent to it