Valvular heart disease

  1. Stenosis is
    Narrowing of any valve orifice impeding systolic or diastolic blood flow
  2. Stenosis can affect what valves?
    All four valvess in the heart
  3. What is the most common cause of  MS?
    Rheumatic fever
  4. MS caused by rheumatic fever results in....
    Inflammation of the leaflets and chordae tendinae, causing thickening and fibrosis
  5. Name five etiologies of MS
    • Congenital (parachute mv)
    • Rheumatic fever 
    • Severe MAC
    • LA Tumor (myxoma)
    • infective endocarditis
  6. Name two congenital forms of MS
    • Parachute MV
    • Mitral arcade
  7. Parachute MV occurs when..
    Theyere is only one papillary muscle in the LV

    (Both CT insert into one papillary muscle)
  8. When does Mitral arcade occurs?
    • When the leaflets are fused at the commissures 
    • (CT are short or nonexistent)
  9. Mitral annular calcification
    Calcfic deposits which occur on the fibrosa of the mitral ring
  10. 50% of patients with MAC also have
  11. Things that can also cause MAC
    • Diabetes 
    • certain cardiomyopathies 
    • stress from MVP
    • hypertension
  12. MS is accompanied with
  13. What are atrial myxomas ?
    Tumors that are often connected by a stalk to the IAS and may plop from the LA into the MV orifice
  14. MV orifice obstruction may also occur due to
    Obstruction by mass or tumor
  15. 2D finding of MS
    • Diastolic doming "hockey-stick" appearance (noted on the AML)
    • LA enlarged 
    • LA thrombus is possible over time
  16. "candle-flame"
  17. Planimetry calculates
  18. Normal MVA range
    4-6 cm2
  19. Mva mild
    1.6-2.0 cm2
  20. Mva moderate
    1.1-1.5 cm2
  21. Mva severe
    1.0 cm2 or less
  22. The higher the________the more severe the stenosis
    Pressure gradient
  23. More severe the stenosis the higher the ____pressure

    Fun fact: pulmonary veins and capillary pressures become elevated resulting in pulmonary edema and CHF
  24. 3 results of MS
    • Lower cardiac output 
    • enlargement of the LA -often causes Afib
    • inadequate movement of blood from the LA results in stasis of blood.(this increases rick for thrombus formation )
  25. What is aortic stenosis ?
    Abnormal narrowing of the valve orifice
  26. Normal aortic valve area
    2-4 cm2
  27. Mild aortic stenosis
    1.0cm to 2 >
  28. Moderate aortic stenosis
    .75 to 1.0 cm2
  29. Severe aortic stenosis
    < .75 cm2
  30. Stenosis of the AOV orifice results in...
    An increase in the velocity of blood flow across the valve correlating to an increase in the pressure gradient across the valve.
  31. Name 3 types of aov stenosis
    • Calcific 
    • congenital- unicuspid or bicuspid 
    • Rheumatic
  32. Rheumatic valve disease normally affects what valve first?
  33. Aov stenosis resulting from rheumatic valve disease is normally found evaluating for,,,
  34. Bicuspid AOV occurs in______% of the population
  35. Bicuspid AOV is associated with______
    coarctation of the aorta
  36. What is the most common cause of AOV stenosis
    Calcific AOV stenosis
  37. Most common cause of tricuspic stenosis is
    Rheumaric valvulitis
  38. Carvallo's sign is
    A ausculatoray finding in tricuspid stenosis indicated by an increase in intensity of the diastolic murmur with inspiration
  39. Severe tricuspid stenosis is present when the valve area is
    1.5 cm2 or less
  40. Normal TV area is
    Greater than 7 cm2
  41. Pulmonic stenosis is usually a result of
    Congenital disease 

    Fun fact: commonly seen with teralogy of fallot
  42. Causes of pulmonary stenosis
    Pulmonary atresia- absence of the valve
  43. Three etiologies of aortic regurgitation
    • Bicuspid /unicuspid
    • calcific valve disease 
    • rheumatic Valve disease
  44. Name the three origins of MVP
    • Valvular - may be a result of myxomatous degeneration(weakening of connective tissues) of leaflets
    • myocardial-asymmetric ventricular contractions, hyperkinetic LV, or hypokinetic LV
    • ischemic -may result in papillary muscle dysfunction
  45. M-mode findings of MVP
    • Abnormal LVPW motion 
    • thickened leaflets
    • LA enlargement
  46. What are homografts?
    Aortic valves that are harvested and cryopreserved and are usually used for pulmonic and aortic valve replacements
  47. Bioprosthetic valve are
    Heterografts of porcine (pig) valves or leaflets can be made up of bovine (cow)
  48. Name the three basic types of mechanical valve
    • Ball-cage valves
    • tilting-disc valve
    • bileaflet valve
  49. _________may be done to repair rather than replace valves.
  50. The most common cause of mitral stenosis is :
    a) myxomatous degeneration
    b) cleft mitral valve
    C) syphilis
    d) rheumatic fever
    D:rheumatic fever
  51. Name the typeof mitral valve deformity that occurs when both chordae insert into a single papillary muscle:
    a)cleft mitral valve 
    b)parachute mitral valve
    c)ebstein's anomaly 
    d)mitral valve prolapse
    B:parachute mitral valve
  52. The most common tumor mass to cause mitral valve obstruction is :
    c)atrial myxoma
    C: atrial myxoma
  53. severe mitral valve stenosis is considered when the mitral valve area is
    a)<10 cm2
    b)<1.0 cm2
    c) 2.0 cm2
    d) 15 cm2
    B:<1.0 cm2
  54. The most common cause of papillary muscle dysfunction is 
    b)defective muscular development
    c)endomyocardial disease 
    d)coronary artery disease
    D:coronary artery disease
  55. when severe aortic stenosis is present the left ventricle walls usually 
    c)stay normal
    d)become decreased in echogenicity
  56. The mosy common congenital malformation of the heart is
    a)unicuspid aortic valve 
    b)parachute mitral valve 
    c) clef aortic valve 
    d)Bicuspid aortic valve
    D: Bicuspid aortic valve
  57. Fine fluttrring of the anterior mitral valve may suggest 

    A) aortic regurgitation
Card Set
Valvular heart disease
Cover all heart valves