Narrowing of any valve orifice impeding systolic or diastolic blood flow
Stenosis can affect what valves?
All four valvess in the heart
What is the most common cause of MS?
Rheumatic fever
MS caused by rheumatic fever results in....
Inflammation of the leaflets and chordae tendinae, causing thickening and fibrosis
Name five etiologies of MS
Congenital (parachute mv)
Rheumatic fever
Severe MAC
LA Tumor (myxoma)
infective endocarditis
Name two congenital forms of MS
Parachute MV
Mitral arcade
Parachute MV occurs when..
Theyere is only one papillary muscle in the LV
(Both CT insert into one papillary muscle)
When does Mitral arcade occurs?
When the leaflets are fused at the commissures
(CT are short or nonexistent)
Mitral annular calcification
Calcfic deposits which occur on the fibrosa of the mitral ring
50% of patients with MAC also have
MR
Things that can also cause MAC
Diabetes
certain cardiomyopathies
stress from MVP
hypertension
MS is accompanied with
MR
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
MV orifice obstruction may also occur due to
Obstruction by mass or tumor
2D finding of MS
Diastolic doming "hockey-stick" appearance (noted on the AML)
LA enlarged
LA thrombus is possible over time
"candle-flame"
MS
Planimetry calculates
MVA
Normal MVA range
4-6 cm2
Mva mild
1.6-2.0 cm2
Mva moderate
1.1-1.5 cm2
Mva severe
1.0 cm2 or less
The higher the________the more severe the stenosis
Pressure gradient
More severe the stenosis the higher the ____pressure
LA
Fun fact: pulmonary veins and capillary pressures become elevated resulting in pulmonary edema and CHF
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 )
What is aortic stenosis ?
Abnormal narrowing of the valve orifice
Normal aortic valve area
2-4 cm2
Mild aortic stenosis
1.0cm to 2 >
Moderate aortic stenosis
.75 to 1.0 cm2
Severe aortic stenosis
< .75 cm2
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.
Name 3 types of aov stenosis
Calcific
congenital- unicuspid or bicuspid
Rheumatic
Rheumatic valve disease normally affects what valve first?
MV
Aov stenosis resulting from rheumatic valve disease is normally found evaluating for,,,
MVS
Bicuspid AOV occurs in______% of the population
1-2
Bicuspid AOV is associated with______
coarctation of the aorta
What is the most common cause of AOV stenosis
Calcific AOV stenosis
Most common cause of tricuspic stenosis is
Rheumaric valvulitis
Carvallo's sign is
A ausculatoray finding in tricuspid stenosis indicated by an increase in intensity of the diastolic murmur with inspiration
Severe tricuspid stenosis is present when the valve area is
1.5 cm2 or less
Normal TV area is
Greater than 7 cm2
Pulmonic stenosis is usually a result of
Congenital disease
Fun fact: commonly seen with teralogy of fallot
Causes of pulmonary stenosis
Pulmonary atresia- absence of the valve
Three etiologies of aortic regurgitation
Bicuspid /unicuspid
calcific valve disease
rheumatic Valve disease
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
M-mode findings of MVP
Abnormal LVPW motion
thickened leaflets
LA enlargement
What are homografts?
Aortic valves that are harvested and cryopreserved and are usually used for pulmonic and aortic valve replacements
Bioprosthetic valve are
Heterografts of porcine (pig) valves or leaflets can be made up of bovine (cow)
Name the three basic types of mechanical valve
Ball-cage valves
tilting-disc valve
bileaflet valve
_________may be done to repair rather than replace valves.
Valvuloplasty
The most common cause of mitral stenosis is :
a) myxomatous degeneration
b) cleft mitral valve
C) syphilis
d) rheumatic fever
D:rheumatic fever
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
The most common tumor mass to cause mitral valve obstruction is :
a)rhabdomyoma
b)sarcoma
c)atrial myxoma
d)teratoma
C: atrial myxoma
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
The most common cause of papillary muscle dysfunction is
a)cardiomyopathy
b)defective muscular development
c)endomyocardial disease
d)coronary artery disease
D:coronary artery disease
when severe aortic stenosis is present the left ventricle walls usually
a)thin
b)hypertrophy
c)stay normal
d)become decreased in echogenicity
B:hypertrophy
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
Fine fluttrring of the anterior mitral valve may suggest