Heart Valves and Cardiomyopathies

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Questions and Answers

What is the primary characteristic of hypertrophic obstructive cardiomyopathy as described in the content?

Ventricular walls are stretched and distended.

Left ventricular walls are stiff, restricting output. (correct)

It leads to muffled heart sounds.

It causes excessive systemic hypotension.

Which treatment method is associated with addressing fluid accumulation in the pericardial space?

Mitral Valve Repair using MitraClip.

Transcatheter aortic valve replacement (TAVR).

Pericardiocentesis. (correct)

Valve-sparing aortic root replacement.

What symptom is most likely to indicate mesenteric ischemia in the context provided?

Tachycardia with a paradoxical pulse.

Severe abdominal rebound tenderness.

Flank pain radiating to the groin.

Diffuse abdominal pain, especially after meals. (correct)

Which of the following interventions is specifically mentioned as part of the treatment for patients experiencing hypotension?

Cool cloths for symptom relief. Signup and view all the answers

What is a possible indicator of kidney issues mentioned in the content?

Flank pain with hematuria. Signup and view all the answers

Which heart valve is located between the right atrium and right ventricle?

Tricuspid valve Signup and view all the answers

What is a notable condition associated with hypertrophic cardiomyopathy?

Sudden cardiac death Signup and view all the answers

Which of the following antibiotics is NOT typically used for treating endocarditis?

Ciprofloxacin Signup and view all the answers

Acute pericarditis is most commonly associated with which syndrome?

Dressler syndrome Signup and view all the answers

What is one of the criteria for diagnosing Kawasaki disease?

Rash with diffuse erythroderma Signup and view all the answers

Which type of cardiomyopathy has the highest incidence of sudden cardiac death?

Hypertrophic cardiomyopathy Signup and view all the answers

Which heart valve is located between the left atrium and left ventricle?

Mitral valve Signup and view all the answers

Which event is NOT associated with post-pericardiotomy syndrome?

Rheumatic heart disease Signup and view all the answers

What is the primary issue associated with stenosis in heart valves?

Thickening and stiffening of the valve Signup and view all the answers

Which of the following medications would likely be contraindicated in a patient with hypertrophic cardiomyopathy?

Digoxin Signup and view all the answers

Which symptom is NOT typically associated with regurgitation or insufficiency of heart valves?

Radiating pain to the left shoulder Signup and view all the answers

Which group of medications is known for reducing fluid overload in patients with heart valve issues?

Diuretics Signup and view all the answers

What is a common complication that can arise from heart valve issues?

Neurological defects Signup and view all the answers

Which medication is typically used for the treatment of Pericarditis?

Simvastatin Signup and view all the answers

What is the primary diagnostic approach for Endocarditis?

Echocardiogram Signup and view all the answers

Which of the following is NOT a common post-operative consideration for valve replacement?

Avoiding antibiotic therapy Signup and view all the answers

Which of the following symptoms is NOT typically associated with Kawasaki Disease?

Increased heart rate and blood pressure Signup and view all the answers

What is the correct characterization of the aortic condition involving stenosis, prolapse, and insufficiency/regurgitation?

Insufficiency/regurgitation leads to backward flow of blood. Signup and view all the answers

Which medication class is commonly used for dilated cardiomyopathy?

Beta-blockers Signup and view all the answers

What is a significant long-term complication of Kawasaki Disease?

Development of aneurysms Signup and view all the answers

The mnemonic 'CRASH and Burn' is used to remember the symptoms of which condition?

Kawasaki Disease Signup and view all the answers

Which of the following is one of the three common complications of endocarditis?

Valvular dysfunction Signup and view all the answers

What does the term 'friction rub' refer to in the context of heart diseases?

A sound created by the rubbing of pericardial layers Signup and view all the answers

What is the common feature of the tissue disorders related to the aortic region?

Change in vessel elasticity Signup and view all the answers

Which symptoms are commonly associated with cerebrovascular incidents?

Confusion and aphasia Signup and view all the answers

Which of these can be indicative of respiratory distress?

Pleuritic chest pain and dyspnea Signup and view all the answers

Which of the following symptoms is NOT commonly associated with systemic conditions in the extremities?

Increased appetite Signup and view all the answers

What is a common treatment option for chronic pericardial effusion?

Pericardial window Signup and view all the answers

Which of these factors could contraindicate a heart transplant?

Severe obesity Signup and view all the answers

What symptom is most likely to last months and affect behavioral response in certain conditions like Kawasaki Disease?

Irritability Signup and view all the answers

Which of the following is considered a sign of endocarditis?

Splinter hemorrhages Signup and view all the answers

What condition is characterized by anxiety, agitation, and rapid heart rate?

Pulmonary embolism Signup and view all the answers

Study Notes

Heart Valves

Tricuspid valve sits between the right atrium & right ventricle
Pulmonic valve is between the right ventricle & the pulmonary artery
Mitral/Bicuspid Valve sits between the left atrium & left ventricle
Aortic valve is between the left ventricle & the aorta

Cardiomyopathies

Hypertrophic Cardiomyopathy is a common cardiomyopathy with a high incidence of sudden cardiac death.
- This is because a thickened septal wall obstructs the aorta/aortic valve, halting the blood flow to the body.
Dilated Cardiomyopathy causes the heart chambers to dilate and stretch resulting in a weakened heart
- Medications used for Dilated Cardiomyopathy:
  - Ace Inhibitors (Lisinopril)
  - Beta-Blockers (Atenolol, Metoprolol, Carvedilol)
  - Calcium Channel Blockers (Nifedipine, Verapamil, Diltiazem)
  - Diuretics (Furosemide)
  - Digoxin
  - Statins (Simvastatin)
  - Aldosterone Antagonists (Spironolactone)
NEVER give Dilated Cardiomyopathy medications for Hypertrophic Cardiomyopathy

Pericarditis

Acute Pericarditis is most commonly associated with Infective Organisms
- Post-Myocardial Infarction Syndrome (Dressler Syndrome)
- Postpericardiotomy Syndrome
- Acute Exacerbation of Systemic Connective Tissue Disorders
Symptoms for Pericarditis:
- FRICTION:
  - Friction rub
  - Fever
  - Radiating substernal pain to the left shoulder, neck, back
  - Increased pain in supine position
  - Chest pain, stabbing
  - Trouble breathing when lying down
  - Inspiration or coughing causes pain
  - Overall feeling sick
  - Noticeable ST-segment elevation
Medications used to treat Pericarditis:
- Pericardiocentesis: Removal of fluid surrounding the heart
- NSAIDS: Ibuprofen
- Colchicine: Decreases inflammation
- Corticosteroids: Help reduce inflammation

Endocarditis

Antibiotics used to treat Endocarditis:
- Penicillin
- Ampicillin
- Vancomycin
- Gentamycin
- Ceftriaxone
- Cefazolin
- Rifampin
Complications of Endocarditis:
- Valvular dysfunction
- Development of Coronary Artery Aneurysms
- Systemic Complications (e.g., renal failure, neurological defects)
How to Diagnose Endocarditis
- Paradoxic Pulse: aka pulsus paradoxus
- Muffled heart sounds
- Tachycardia
- Hypotension
- Spleen: Sudden abdominal pain and radiation to left shoulder with abdominal rebound tenderness
- Kidneys: Flank pain radiating to groin, hematuria, pyuria
- Mesenteric: Diffuse abdominal pain, especially after eating, abdominal distention
- CNS: TIA/Stroke symptoms, confusion, reduced concentration, aphasia, dysphasia, etc
- Lungs: Pleuritic chest pain, dyspnea, cough, anxiety, agitation, restlessness, rapid HR
- Systemic/Extremities: Petechiae, Janeway lesions, Osler's nodes, splinter hemorrhages, Roth spots
Treatments for Endocarditis
- Antibiotics
- Surgery
- Valve replacement/repair
- Pericardial window

Kawasaki Disease

Diagnosis Criteria:
- Fever for 5+ days
- At least 4/5 of the following:
  - Cervical lymphadenopathy
  - Rash with diffuse erythroderma
  - Changes in oral mucosa (erythema, cracking, oropharyngeal reddening, strawberry tongue)
  - Bilateral conjunctival injection without exudate
  - Changes in the extremities (edema/erythema on palms and soles, periungual desquamation of hands and feet)
Treatments for Kawasaki Disease:
- High dose intravenous immunoglobulin (IVIG): Helps reduce and prevent inflammation
- Aspirin: Given in high doses to manage the fever and inflammation
- Corticosteroids: May be used for severe cases
Long Term Complications of Kawasaki disease:
- Coronary artery aneurysms
- Heart failure
Discharge Education:
- Irritability may last for 2 weeks
- Avoid contact sports until cleared by a doctor
- Follow up appointments are crucial for monitoring heart function, for potential coronary artery aneurysms
- Look for signs of heart failure (e.g., shortness of breath, fatigue, swelling in the legs)
- CRASH and Burn:
  - Conjunctivitis
  - Rash
  - Adenopathy
  - Stroke (rare complication)
  - Hand and foot changes
  - Burning mouth
  - Urinary tract infection
  - Rheumatoid arthritis
  - Neuropathy
  - Burn: Desquamation (peeling of skin)

Valve Replacement

Types of valve replacements:
- Mechanical: Durable, but require lifelong anticoagulation (blood thinners)
- Bioprosthetic (tissue): Derived from animal tissue, they last around 10-15 years but do not require lifelong anticoagulation
- Homograft (human): Human tissue that is donated, lasts up to 15 years, but not widely available
- Autograft (patient's own tissue): Using a valve from a different part of the patient's body, the most durable option but has the most complex surgery
Post-operative Education:
- Procedural:
  - Valvuloplasty,
  - Transcatheter aortic valve replacement (TAVR),
  - Transcatheter mitral valve repair (Mitra clip)
- Surgical:
  - Valve replacement,
  - Valve annuloplasty,
  - Commisurotomy,
  - Valve-sparing aortic root replacement,
  - Ross procedure

Chronic Pericardial Effusion

Treatments:
- Pericardial window
- Medications to reduce inflammation
Relative Contraindications for Heart Transplant:
- Severe Obesity
- Active Malignancy
- Severe Chronic Lung Disease
- Active Substance Abuse
- Severe Untreated Mental Illness

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Description

This quiz covers essential information about heart valves and various types of cardiomyopathies. You'll explore the anatomy of the heart's valves and the impact of different cardiomyopathies on heart function, including treatment options. Test your knowledge of critical terms and concepts in cardiology.