34 Valvular Disease
![](https://photos.thisispiggy.com/file/wikiFiles/svuOenR.jpg)
- children with strep infection
- blood volume goes up in pregnancy, symptomatic
![](https://photos.thisispiggy.com/file/wikiFiles/5wvCp3M.jpg)
Aortic Stenosis
![](https://photos.thisispiggy.com/file/wikiFiles/3YOuGGX.jpg)
![](https://photos.thisispiggy.com/file/wikiFiles/v1tHDc3.jpg)
![](https://photos.thisispiggy.com/file/wikiFiles/bhoRoDd.jpg)
- exception to aging
- stenosis in 50s: bicuspid valve
- The three major causes of valvular aortic stenosis are a congenitally abnormal valve with calcification (e.g. bicuspid valve), a calcified normal valve, or rheumatic heart disease. Although rheumatic heart disease is the most common cause worldwide, calcific aortic valve disease (in either a bicuspid or tricuspid valve) is more common in the United States.
![](https://photos.thisispiggy.com/file/wikiFiles/Rd7yvY2.jpg)
![](https://photos.thisispiggy.com/file/wikiFiles/HRmKCKh.jpg)
- 2 leaflets fused together, not opening
- avoid meds that decreases cardiac output (beta blockers, diuretics)
- surgery with anesthesia places pts more at risks by inhibiting sympathetic response
Mitral Stenosis
![](https://photos.thisispiggy.com/file/wikiFiles/o1bjDKC.jpg)
- ventricle normal but just less blood
![](https://photos.thisispiggy.com/file/wikiFiles/tBIfk8V.jpg)
![](https://photos.thisispiggy.com/file/wikiFiles/zRROoV3.jpg)
- hemoptysis: very high pressure in lung
- afib: dilated atrium due to volume overload, complication = stroke
![](https://photos.thisispiggy.com/file/wikiFiles/WC2qSiF.jpg)
- mitral valve in middle can't open
Aortic Regurge
![](https://photos.thisispiggy.com/file/wikiFiles/9Ug5v5Z.jpg)
- increased preload/stroke volume: ventricle has to pump blood twice
![](https://photos.thisispiggy.com/file/wikiFiles/nnQK76A.jpg)
- HTN: thoracic aortic aneurysm
- endocarditis: damaged heart valve
![](https://photos.thisispiggy.com/file/wikiFiles/vu8fi3G.jpg)
- also occurs with PDA, AV fistula. Anything with leakage of blood out of aorta
- water hammer pulses: strong bounding pulses
- head bobbing: get dizzy when bp low
- Pulsus bisferiens, also known as a biphasic pulse, refers to two strong systolic pulses with a mid-systolic dip, in other words, two pulses during systole. It can be seen in aortic regurgitation with or without aortic stenosis and hypertrophic cardiomyopathy.
![](https://photos.thisispiggy.com/file/wikiFiles/cWrBC4e.jpg)
Mitral Regurge
![](https://photos.thisispiggy.com/file/wikiFiles/rmDe5hZ.jpg)
- heart has to pump blood twice
![](https://photos.thisispiggy.com/file/wikiFiles/QmnDMpU.jpg)
- papillary muscle damage
- functional MR: leaflets too far apart
![](https://photos.thisispiggy.com/file/wikiFiles/sENLp4e.jpg)
- down syndrome: EDC defect. Affect mitral leaflet
- cleft mitral valve: one of leaflets has a piece missing
![](https://photos.thisispiggy.com/file/wikiFiles/WiDh7oS.jpg)
![](https://photos.thisispiggy.com/file/wikiFiles/XcsfXYC.jpg)
![](https://photos.thisispiggy.com/file/wikiFiles/AdjnIpH.jpg)
- choose medication that lowers afterload, increase forward flow
Tricuspid and Pulmonic
![](https://photos.thisispiggy.com/file/wikiFiles/MgSM3vb.jpg)
![](https://photos.thisispiggy.com/file/wikiFiles/setpW4m.jpg)
![](https://photos.thisispiggy.com/file/wikiFiles/sPOvoGV.jpg)
Valve surgery
_
![](https://photos.thisispiggy.com/file/wikiFiles/1cv7vaz.jpg)
![](https://photos.thisispiggy.com/file/wikiFiles/HMfCGvY.jpg)
![](https://photos.thisispiggy.com/file/wikiFiles/njkDCyo.jpg)
Backlinks