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Valvular Heart Disease Notes

This is a sample of our (approximately) 4 page long Valvular Heart Disease notes, which we sell as part of the Clinical Cardiology Notes collection, a 2:1 package written at Bristol University in 2014 that contains (approximately) 39 pages of notes across 18 different documents.

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Valvular Heart Disease Revision

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Valvular Heart Disease Aortic Valve

Tri-leaflet structure Usual pathology is either: o Calcification with functional and structural stenosis or o Destruction of the leaflets with resultant insufficiency Aortic Stenosis (AS)
 Causes o Senile calcific stenosis o Calcification of a congenital (bicuspid) valve o Rheumatic heart disease (secondary to RF i)
 Pathology o CONCENTRIC LEFT VENTRICULAR HYPERTROPHY o Ventricular dilatation as a result of outflow obstruction
 Symptoms include o SOB o Angina o Syncope o Those of CHF - orthopnoea, PND, oedema
 Signs include a o Holo-systolic murmur at the right second ICS radiating to the carotids o Weak and delayed peripheral pulses
 Invesitgations o CXR shows minimal changes initially but cardiomegaly later o Diagnosis is by ECHO and if +ve then cardiac catheterisation (inc pressure across valve)
 Indications for surgery: o Symptoms o Increase in left ventricular end systolic volume o Procedure of choice is Aortic Valve Replacement (AVR), repair may be done rarely and with poor short term results. AVR may be accomplished with either a mechanical or bioprosthetic heart valve. Prognosis poor - life expectancy 2-3 years, the greatest risk is that of sudden cardiac death. Aortic Regurgitation / Insufficiency (AI)
 Casues o (>40) aortic degeneration o (<40 y/o) Marfan's syndrome
 Most frequently presents in combination with Aortic Stenosis. Other aetiologies incl.: o Endocarditis o Aneurysm o Congenital (bicuspid) o Luetic o Traumatic o Rheumatic o Atherosclerotic o Ankylosing spondylitis o Dissection o Iatrogenic
 Symptoms usually include: o SOB

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