Chapter 11: Valvular Heart Disease Flashcards

1
Q

A febrile illness with widespread connective tissue acute

inflammation but especially heart and joints

A

Rheumatic fever (RF)

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2
Q

True or false: Rheumatic fever is a hypersensitivity reaction.

A

True

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3
Q

What causes rheumatic heart disease (RHD) a complication of? What does it result in?

A

Scarring of heart valves by rheumatic fever

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4
Q

True or false: Rheumatic fever is a bacterial infection.

A

False; it is an immunologic complication following infection by group A beta hemolytic Streptococcus

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5
Q

How do you prevent Rheumatic fever?

A

Treat beta-Strep promptly.

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6
Q

How do you prevent Rheumatic heart disease in folks who have had RF before?

A

Provide prophylactic penicillin throughout childhood and young adulthood to prevent additional strep infections , recurrent RF, and further valve damage.

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7
Q

What type of valvular disease may occur as a
result of a congenital bicuspid aortic valve
abnormality or calcific aortic stenosis?

A

Nonrheumatic Aortic Stenosis

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8
Q

In what two ways can Nonrheumatic Aortic Stenosis occur?

A

1) Congenital bicuspid aortic valve abnormality

2) Calcific aortic stenosis

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9
Q

Which part of the heart is strained by calcific aortic stenosis?

A

Left ventricle

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10
Q

What is the treatment for calcific aortic stenosis?

A

prosthetic valve replasement

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11
Q

What is the top cause of valve replacement in the US and Europe?

A

Calcific aortic stenosis

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12
Q

True or false: the same risk factors that predispose a person to CAD also predispose a person to CAS (cardiac aortic stenosis).

A

True

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13
Q

How is mitral valve prolapse diagnosed?

A

echocardiogram

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14
Q

How is mitral valve prolapse treated?

A

Treat prophylactically with ABX prior to dental/surgical procedures; Valve repair or replacement if severe.

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15
Q

What are the two major types of prosthetic heart valves?

A

1) Mechanical

2) Bioprosthetic

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16
Q

What does an artificial heart valve increase the risk of?

A

Infective endocarditis

17
Q

What is the downfall of mechanical valve replacements?

A

Increased risk of blood clots

18
Q

On valves of which side of the heart is infective endocarditis usually seen?

A

Left side

19
Q

True or false: Subacute infective endocarditis is usually caused by highly virulent organisms.

A

False; low virulence

20
Q

Why do people with heart valve damage or artificial valves go on prophylactic antibiotic prior to dental or surgical procedures?

A

To prevent subacute infective endocarditis

21
Q

Which valve in the heart is most often infected by acute infective endocarditis?

A

R tricuspid valve (because this is soon after blood enters heart)

22
Q

True or false: Acute valve infections tend to affect valves on the L side of the heart.

A

False; right side

23
Q

What type of condition is rheumatic fever?

A

Acute autoimmune hypersensitivity

24
Q

How can rheumatic heart disease occur?

A

1) Strep infection
2) A couple of weeks later, rheumatic fever (body creates Abs against strep that attack joints and heart valve–especially the mitral valve).
3) This usually resolves with some scarring
4) Repeated scarring from additional strep infections leads to RHD

25
Q

What are the possible outcomes of RHD?

A

1) Stiff valves cause heart to work harder

2) Blood backs up to congest lungs

26
Q

What are the two main types of nonrheumatic aortic stenosis?

A

1) Congenital bicuspid valve (born with tricuspid valve containing 2 instead of 3 cusps)
2) Calciforic aortic stenosis

27
Q

What are the 5 main conditions affecting heart valves?

A

1) Rheumatic heart disease
2) Non-rheumatic heart disease
3) Mitral valve prolapse
4) Artificial valves
5) Infective endocarditis

28
Q

What is the prognosis for someone with calcific aortic stenosis with no valve replacement?

A

less than 5 years

29
Q

True or false: Infective endocarditis is common, but usually not serious.

A

False; it is rare, but usually serious.

30
Q

True or false: Patients with artificial heart valves are less vulnerable to endocarditis.

A

False; more vulnerable

31
Q

_______________ endocarditis is caused by low levels of low virulence bacteria.

A

Subacute

32
Q

_______________ endocarditis is caused by highly virulent bacteria (often staph).

A

Acute

33
Q

Which valve is usually affected by acute endocarditis?

A

R AV valve (tricuspid); because it is the first encountered in blood flow through the heart