Lilly Chapter 8 Valvular Heart Disease Part II
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- Describe ARF. Process? Pathogen? Pathognomic Histology?
- Inflammatory response to GAS that elicits immune response and eventually becomes autoimmune. Visualization of Aschoff bodies (fibrinoid necrosis).
- What is the treatment for ARF? What value does it preferentially injure?
- Penicillin + Anti-inflammatories (ASA)treatment; mitral valve (often Stenosis)
- True/False - RF is most often the cause of MS.
- True
- What are the common structural changes to the mitral valve in RF? At what point does MS become significant?
- calcification, commisure fusion, thickening & shortening of the chordae tendinae. Area is less than 2 cm.
- What condition that exists in 2 forms is often a complication in MS?
- Pulmonary HTN: passive (PA pressure increase) or reactive (PA vessel thickening)
- What PE findings (palpation, murmurs, S1) are apparent in mild mitral stenosis?
- RV tap; loud S1; diastolic OS with decresendo murmur;
- What EKG findings in MS?
- large R in V1 (RV hypertrophy); diphasic P wave (LA dilatation)
- True/False - Myxomatous degeneration often causes Mitral Regurgitaion and Prolapse.
- True
- Acute MR produces what effect on LA pressure measurements?
- prominent v wave (often merges with c wave)
- How do chronic MR and acute MR's clinical presentation differ?
- acute = pulmonary congestion, dyspnea; chronic = reduced cardiac output i.e. fatigue, weakness
- Mitral Valve Prolapse is often asymptomatic. What 2 maneuvers help distinguish the MVP murmur?
- Squatting (increase Volume, delay occurrence); Standing (decrease volume earlier occurence)