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Valvular Heart Disease Notes

Medicine Notes > Clinical Cardiology Notes

This is an extract of our Valvular Heart Disease document, which we sell as part of our Clinical Cardiology Notes collection written by the top tier of Bristol University students.

The following is a more accessble plain text extract of the PDF sample above, taken from our Clinical Cardiology Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

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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