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Barry Patho 2
6-20-10 Patho II Valve Dz+...
| Question | Answer |
|---|---|
| The most frequent cause for aquired valvular heart disease is | The Rheumatic Fever |
| The most frequently affected valves from Rheumatic Fever are (from most frequent to least) | Mitral, Aortic, Tricuspid, and Pulmonary |
| 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 |
| Three Scaring conditions related to rheumatic fever | Migratory polyarthritis (has to due with joints and gonorrhea), Erythema Marginatum (red ring dermatitis), and Carditis. |
| The most serious scaring due to the rheumatic fever is | The scars produced in the heart valves (endocarditis) |
| The Fibrotic lesions in the valves involving the chordae tendinae, cusps, and annulus cause what 2 things | Prolapse and Stenosis |
| 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 |
| Annulus is | A ring shaped structure |
| T/F: Prolapse valve creates insufficiency | True |
| When cusps fuse or become thick, ridig, and calcified it is called | Stenosis |
| What is the most common disease process affecting the Pulmonic valve | Cogenital |
| What Dz process is the Mitral valve most affected by | Rheumatic fever |
| What Dz process is the Aortic valve most affected by | Rheumatic fever, Senile (getting old), and Atherosclerosis |
| 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 |
| What Dz process is Multivalvular most affected by | Rheumatic fever |
| 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 |
| What word describes Stenosis and Prolapsed regarding blood flow | They are "opposite" - one remains closed the other remains open |
| When blood flows backward through a valve it is called | Regurgitation |
| An insufficient-valve is also called a | Prolapsed valve |
| 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) |
| What arrhythmia is associated with an enlarged left atrium | A-fib |
| 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) |
| 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 |
| What is the Medical Treatment for Asymptomatic (or minimal symptomatic) Mitral Valve Stenosis | Diuretics, decreased Na intake, decreased exercise, PCN, - (NO SURGICAL INTERVENTION) |
| What is the treatment for severe Mitral Valve Stenosis | Surgery and ballon pump |
| Name 3 Mitral valve surgeries | Closed Mitral Valvulotomy, Open Commissurotomy, Mitral Valve Replacement |
| T/F: Mitral valve regurge is more common in men | True |
| What physically causes Mitral Regurgitation (MR) | 1)Rigid & Deformed Cusps 2)Shortening and Fusion of the Chordae Tendinae and Papillary Muscle - causing Cusps retraction |
| 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) |
| What is the goal of medical treatment in an asymptomatic MR patient | To reduce Afterload and Left Ventricular volume (use of vasodilators) |
| What is the surgical treatment of MR | Reconstruction and replacement |
| 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 |
| What are the body's compensatory mechanisms for decreased stroke volume | Increase pressure and strength of contraction |
| 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) |
| 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 |
| Myocardial ischemia (in regards to Aortic Valve issues) are a result of | Increased Ventricular Pressures and Hypertrophy that cause Compression on Coronary Arteries |
| Medical treatment of asymptomatic Aortic Stenosis/Regurgitation are | Decrease exercise (Surgery not for asymptomatic pt) |
| Surgical treatment for Aortic Stenosis/ Regurg is | Replacement (only if symptomatic) |
| What are the S/S of Pericarditis | Acute (severe) Chest Pain, Pericardial Effusion (too much = cardiac tamponade) |
| What may happen to the Pericardium in Pericarditis | It thickens and adheres to the heart ("Adhesive Pericarditis"), causes constrictive pericarditis |
| What is the surgical intervension for Pericarditis | Removal of Pericardium |
| What fluid around the heart causes Cardiac Tamponade | Blood |
| Cardiac Tamponade cascade is | Decreased venous return leads to decreased left heart output causes decreased BP which results in Shock |
| Cardiac Tamponade treatment includes | Direct Percutaneous Puncture |
| What is the primary cause of Cardiomyopathies | It's unknown |
| 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 |
| T/F: Cardiomyopathies are the result of pericardial, hypertensive, cogenital, valvular, and ischemic diseases | False |
| 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 |
| T/F: Cardiomyopathies are the result of pericardial, hypertensive, cogenital, valvular, and ischemic diseases | False |
Created by:
smorrissey1
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