6-20-10 Patho II Valve Dz+...
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| The most frequent cause for aquired valvular heart disease is | The Rheumatic Fever
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| The most frequently affected valves from Rheumatic Fever are (from most frequent to least) | Mitral, Aortic, Tricuspid, and Pulmonary
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| T/F: Rheumatic fever is an infectious process | False; It is actually a delayed hyper reaction of the immune system from a bacterial infection (group A B- hemolytic Streptococcus) that was previously resolved years before
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| Three Scaring conditions related to rheumatic fever | Migratory polyarthritis (has to due with joints and gonorrhea), Erythema Marginatum (red ring dermatitis), and Carditis.
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| The most serious scaring due to the rheumatic fever is | The scars produced in the heart valves (endocarditis)
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| The Fibrotic lesions in the valves involving the chordae tendinae, cusps, and annulus cause what 2 things | Prolapse and Stenosis
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| What changes create a prolapsed valve | Shorting of one or more cusps, shortening and fusing of Chordae Tendinae, Papillary Musc, dilation of valve ring, which leads to regurgitation
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| Annulus is | A ring shaped structure
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| T/F: Prolapse valve creates insufficiency | True
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| When cusps fuse or become thick, ridig, and calcified it is called | Stenosis
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| What is the most common disease process affecting the Pulmonic valve | Cogenital
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| What Dz process is the Mitral valve most affected by | Rheumatic fever
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| What Dz process is the Aortic valve most affected by | Rheumatic fever, Senile (getting old), and Atherosclerosis
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| What Dz process is the Tricuspid valve most affected by | Rheumatic fever - causes Stenosis leading to increased vent. pressure causes regurge resulting in Right vent. hypertrophy
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| What Dz process is Multivalvular most affected by | Rheumatic fever
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| Summarize what happen with Mitral valve disease | Rheumatic lesions on adjacent valve leaflets, edges stick together, scar, fuse and become solid, obstruct blood flow, this is Stenosis
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| What word describes Stenosis and Prolapsed regarding blood flow | They are "opposite" - one remains closed the other remains open
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| When blood flows backward through a valve it is called | Regurgitation
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| An insufficient-valve is also called a | Prolapsed valve
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| What happens with a Prolapsed Mitral Valve | An increase in left artial pressure causes pulmonary HTN, leads to pulmonary edema, causes right heart hypertrophy (starting in RV)
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| What arrhythmia is associated with an enlarged left atrium | A-fib
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| What are the S/S of mild Mitral valve stenosis (5 of them) | Hemoptysis (coughing up blood), CP, Throboembolism, Endocarditis (infective), Hoarseness (compression of left recurrent laryngeal nerve)
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| What are S/S of servere Mitral Valve stenosis with increased PVR and RHF (5 of them) | Systemic venous hypertrophy, Hepatomegaly, Edema, Ascites, and Hydrothorax
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| What is the Medical Treatment for Asymptomatic (or minimal symptomatic) Mitral Valve Stenosis | Diuretics, decreased Na intake, decreased exercise, PCN, - (NO SURGICAL INTERVENTION)
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| What is the treatment for severe Mitral Valve Stenosis | Surgery and ballon pump
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| Name 3 Mitral valve surgeries | Closed Mitral Valvulotomy, Open Commissurotomy, Mitral Valve Replacement
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| T/F: Mitral valve regurge is more common in men | True
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| What physically causes Mitral Regurgitation (MR) | 1)Rigid & Deformed Cusps 2)Shortening and Fusion of the Chordae Tendinae and Papillary Muscle - causing Cusps retraction
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| What are the S/S of Mitral Valve Regurgitation | Decreased CO (Most Important S/S), increased Pulmonary pressure, Left Ventricular dysfunction, RHF (Edema, Hepatomegaly, Acites)
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| What is the goal of medical treatment in an asymptomatic MR patient | To reduce Afterload and Left Ventricular volume (use of vasodilators)
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| What is the surgical treatment of MR | Reconstruction and replacement
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| T/F: Aortic Valve Regurgitation and Stenosis both have decreased net stroke volume output | True: Stenosis r/t less going to artery, Regurg r/t blood flowing backward from artery
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| What are the body's compensatory mechanisms for decreased stroke volume | Increase pressure and strength of contraction
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| What are the negative effects of increasing the pressure and strength of cardiac contraction in a pt with MR | Hypertrophy of left vent., Ventricular dilatation (decr. CO), increased volume of blood in LA, increased pulmonary pressure (causes pulmonary edema)
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| An increase in blood volume (from peripheral circ. reflexes) and decreased BP leads to | Decreased Renal blood flow and urine output, increase in RBC Mass to compensate for hypoxia
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| Myocardial ischemia (in regards to Aortic Valve issues) are a result of | Increased Ventricular Pressures and Hypertrophy that cause Compression on Coronary Arteries
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| Medical treatment of asymptomatic Aortic Stenosis/Regurgitation are | Decrease exercise (Surgery not for asymptomatic pt)
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| Surgical treatment for Aortic Stenosis/ Regurg is | Replacement (only if symptomatic)
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| What are the S/S of Pericarditis | Acute (severe) Chest Pain, Pericardial Effusion (too much = cardiac tamponade)
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| What may happen to the Pericardium in Pericarditis | It thickens and adheres to the heart ("Adhesive Pericarditis"), causes constrictive pericarditis
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| What is the surgical intervension for Pericarditis | Removal of Pericardium
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| What fluid around the heart causes Cardiac Tamponade | Blood
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| Cardiac Tamponade cascade is | Decreased venous return leads to decreased left heart output causes decreased BP which results in Shock
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| Cardiac Tamponade treatment includes | Direct Percutaneous Puncture
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| What is the primary cause of Cardiomyopathies | It's unknown
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| What is the definition of Cardiomyopathy | They constitute a group of diseases in which the dominant feature is direct involvement of the heart muscle itself
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| T/F: Cardiomyopathies are the result of pericardial, hypertensive, cogenital, valvular, and ischemic diseases | False
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| What is the definition of Cardiomyopathy | They constitute a group of diseases in which the dominant feature is direct involvement of the heart muscle itself
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| T/F: Cardiomyopathies are the result of pericardial, hypertensive, cogenital, valvular, and ischemic diseases | False
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