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Barry Patho 2

6-20-10 Patho II Valve Dz+...

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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