Mastering Heart Anatomy
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Questions and Answers

Which type of valvular disease is characterized by failure to open completely and obstructs forward flow?

  • Hypertrophy
  • Insufficiency
  • Stenosis (correct)
  • Regurgitation

    • What is the main cause of regurgitation of blood in valvular disease?

  • Disruption of supporting structures
  • Intrinsic disease of cusps (correct)
  • Chronic process
  • Primary cuspal abnormality

    • Which type of valvular disease leads to pressure overload cardiac hypertrophy?

  • Stenosis (correct)
  • Regurgitation
  • Hypertrophy
  • Insufficiency

    • What is the most common cause of acquired stenosis of aortic and mitral valves?

    <p>Rheumatic Fever</p> Signup and view all the answers

    What is the characteristic lesion in chronic Rheumatic Fever?

    <p>Fibrotic valvular disease</p> Signup and view all the answers

    What is the main cause of Rheumatic Fever?

    <p>Group A β-hemolytic streptococcal infection</p> Signup and view all the answers

    What percentage of all live births have bicuspid aortic valve?

    <p>1-2%</p> Signup and view all the answers

    What is the genetic mutation associated with bicuspid aortic valve?

    <p>NOTCH1 mutations</p> Signup and view all the answers

    Which structure can be seen just above the aortic valve?

    <p>The coronary artery orifices</p> Signup and view all the answers

    What color is the myocardium beneath the endocardium?

    <p>Red-brown</p> Signup and view all the answers

    What can be seen above the aortic valve?

    <p>A smooth intima with no atherosclerosis</p> Signup and view all the answers

    What attaches the leaflet margins of the mitral valve to the papillary muscles?

    <p>Chordae tendineae</p> Signup and view all the answers

    How many cusps does the aortic valve have?

    <p>Three</p> Signup and view all the answers

    What is the texture of the leaflets of the tricuspid valve?

    <p>Thin and delicate</p> Signup and view all the answers

    What is the name of the valve that is similar to the mitral valve?

    <p>Bicuspid valve</p> Signup and view all the answers

    Which valve is affected in 70% of cases of Rheumatic Fever?

    <p>Mitral valve</p> Signup and view all the answers

    What is the main cause of acquired stenosis of the aortic and mitral valves?

    <p>Rheumatic Fever</p> Signup and view all the answers

    What is the main cause of regurgitation of blood in valvular disease?

    <p>Intrinsic disease of cusps</p> Signup and view all the answers

    What is the most common cause of pancarditis in Rheumatic Fever?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a minor criteria for the diagnosis of Rheumatic Fever?

    <p>Fever</p> Signup and view all the answers

    What is the characteristic lesion in chronic Rheumatic Fever?

    <p>Mitral stenosis</p> Signup and view all the answers

    What is the main cause of acute Rheumatic Fever?

    <p>Untreated Group A streptococcal (GAS) pharyngitis</p> Signup and view all the answers

    What is the main cause of volume overload in valvular disease?

    <p>Regurgitation of blood</p> Signup and view all the answers

    What is the characteristic lesion seen in ACTUTE Rheumatic Fever?

    <p>Verrucous vegetations</p> Signup and view all the answers

    What is the main cause of pancarditis in Rheumatic Fever?

    <p>Aschoff bodies</p> Signup and view all the answers

    Which valve is virtually always involved in Rheumatic Fever?

    <p>Mitral valve</p> Signup and view all the answers

    What is the most common morphology of chronic rheumatic fever?

    <p>All of the above</p> Signup and view all the answers

    What attaches the leaflet margins of the mitral valve to the papillary muscles?

    <p>Chordae tendineae</p> Signup and view all the answers

    Which of the following is a characteristic of Erythema marginatum?

    <p>Raised edges</p> Signup and view all the answers

    Which cells are primarily found in Aschoff bodies?

    <p>T lymphocytes</p> Signup and view all the answers

    Which cardiac condition is associated with scattered Aschoff bodies?

    <p>Myocarditis</p> Signup and view all the answers

    Which valve is virtually always involved in chronic rheumatic fever?

    <p>Mitral valve</p> Signup and view all the answers

    Which cells are primarily found in Aschoff bodies?

    <p>Plasma cells</p> Signup and view all the answers

    What is the most common cause of aortic stenosis?

    <p>Calcific aortic degeneration</p> Signup and view all the answers

    What is the most common cause of mitral valve prolapse?

    <p>Connective tissue disorders</p> Signup and view all the answers

    What is the main complication of aortic stenosis?

    <p>All of the above</p> Signup and view all the answers

    What is the main symptom of mitral valve prolapse?

    <p>Midsystolic click</p> Signup and view all the answers

    What does pericarditis lead to in acute rheumatic fever?

    <p>Fibrinous exudate</p> Signup and view all the answers

    What is the main cause of pancarditis in rheumatic fever?

    <p>Aschoff bodies</p> Signup and view all the answers

    What is the texture of the leaflets in mitral valve prolapse?

    <p>Floppy</p> Signup and view all the answers

    What is the morphology of calcific aortic stenosis?

    <p>Calcified masses (hydroxyapatite deposits)</p> Signup and view all the answers

    Which cells are primarily found in Aschoff bodies?

    <p>Macrophages</p> Signup and view all the answers

    What is the characteristic lesion seen in acute Rheumatic Fever?

    <p>Aschoff bodies</p> Signup and view all the answers

    What is the main characteristic of the spongiosa layer in myxomatous degeneration?

    <p>Proteoglycan deposition</p> Signup and view all the answers

    Which layer of the mitral valve shows disorganized elastin in myxomatous degeneration?

    <p>Atrialis</p> Signup and view all the answers

    Which of the following best describes the morphology of myxomatous degeneration in mitral valve prolapse?

    <p>Ballooning of the leaflets</p> Signup and view all the answers

    Which group of organisms is included in the HACEK group?

    <p>Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella</p> Signup and view all the answers

    Which valves are most commonly infected in infective endocarditis?

    <p>Aortic and mitral valves</p> Signup and view all the answers

    What are the clinical features of infective endocarditis?

    <p>Fever, fatigue, weight loss, flu-like symptoms</p> Signup and view all the answers

    What are the microemboli associated with infective endocarditis?

    <p>Petechiae, splinter hemorrhages, retinal hemorrhages (Roth spots)</p> Signup and view all the answers

    What is the morphology of infective endocarditis vegetations?

    <p>Friable, bulky, and destructive</p> Signup and view all the answers

    What is the frequent target valve in infective endocarditis in patients who use IV drugs?

    <p>Tricuspid valve</p> Signup and view all the answers

    Which type of infective endocarditis is caused by highly virulent organisms attacking a previously normal valve?

    <p>Acute infective endocarditis</p> Signup and view all the answers

    Which type of infective endocarditis is caused by organisms of low virulence affecting a previously abnormal valve?

    <p>Subacute infective endocarditis</p> Signup and view all the answers

    Which type of infective endocarditis follows a protracted course of weeks to months?

    <p>Subacute infective endocarditis</p> Signup and view all the answers

    Which organisms are responsible for 50-60% of infective endocarditis cases affecting damaged or deformed valves?

    <p>Streptococcus viridans</p> Signup and view all the answers

    Which organisms are the major cause of infective endocarditis in patients who use intravenous drugs?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Which of the following is a clinical feature of infective endocarditis?

    <p>Murmurs in 90% with left-sided lesions.</p> Signup and view all the answers

    What is the pathogenesis of infective endocarditis?

    <p>Infection of the heart valves by bacteria.</p> Signup and view all the answers

    What is the initial step in the pathogenesis of infective endocarditis?

    <p>Seeding of the blood with microbes.</p> Signup and view all the answers

    Which of the following is the main characteristic of infective endocarditis?

    <p>A and B only</p> Signup and view all the answers

    What is the morphology of infective endocarditis vegetations?

    <p>Ring abscess</p> Signup and view all the answers

    Which type of cardiomyopathy is characterized by progressive cardiac dilation and contractile dysfunction usually with hypertrophy?

    <p>Dilated cardiomyopathy</p> Signup and view all the answers

    What are the acquired causes of dilated cardiomyopathy?

    <p>All of the above</p> Signup and view all the answers

    Which gene mutation is most commonly associated with dilated cardiomyopathy?

    <p>Mutation affecting cytoskeletal protein, X-linked</p> Signup and view all the answers

    What is the morphology of dilated cardiomyopathy?

    <p>Enlarged heart with flabby chambers</p> Signup and view all the answers

    What are the clinical features commonly seen in dilated cardiomyopathy?

    <p>Dyspnea and easy fatigability</p> Signup and view all the answers

    What is the most common cause of aortic stenosis?

    <p>Degenerative calcification</p> Signup and view all the answers

    Which type of infective endocarditis follows a protracted course of weeks to months?

    <p>Subacute infective endocarditis</p> Signup and view all the answers

    Which condition is characterized by the deposition of sterile thrombi on valves?

    <p>Nonbacterial thrombotic endocarditis</p> Signup and view all the answers

    Where are the vegetations typically located in nonbacterial thrombotic endocarditis?

    <p>Along the line of closure of leaflets/cusps</p> Signup and view all the answers

    Which condition is characterized by sterile, small vegetations on valves of patients with SLE?

    <p>Libman-Sacks endocarditis</p> Signup and view all the answers

    What is the histological appearance of Libman-Sacks endocarditis?

    <p>Fibrinous, pink material with cellular debris</p> Signup and view all the answers

    What is the characteristic lesion seen in infective endocarditis?

    <p>Large, irregular masses on the valve cusps</p> Signup and view all the answers

    Where are the vegetations typically located in Libman-Sacks endocarditis?

    <p>On the valve undersurface, cords, and endocardial surfaces</p> Signup and view all the answers

    Which condition is characterized by small or medium-sized vegetations on either or both sides of the valve leaflets?

    <p>Libman-Sacks endocarditis</p> Signup and view all the answers

    Which type of endocarditis is characterized by large, irregular masses on the valve cusps that can extend onto the chordae?

    <p>Infective endocarditis</p> Signup and view all the answers

    Which type of endocarditis typically exhibits small, bland vegetations, usually attached at the line of closure?

    <p>Nonbacterial thrombotic endocarditis</p> Signup and view all the answers

    Which type of cardiomyopathy is the most common?

    <p>Dilated cardiomyopathy</p> Signup and view all the answers

    What is the most common genetic cause of dilated cardiomyopathy?

    <p>Autosomal dominant inheritance</p> Signup and view all the answers

    What is the histological appearance of dilated cardiomyopathy?

    <p>All of the above</p> Signup and view all the answers

    At what age is dilated cardiomyopathy commonly diagnosed?

    <p>20-50 years</p> Signup and view all the answers

    What is the main cause of death in patients with dilated cardiomyopathy?

    <p>Heart failure</p> Signup and view all the answers

    What is the most common complication of dilated cardiomyopathy?

    <p>All of them</p> Signup and view all the answers

    Which condition is characterized by the deposition of extracellular proteins in the heart?

    <p>Amyloidosis (Restrictive Cardiomyopathy)</p> Signup and view all the answers

    Which genetic mutation is associated with Hypertrophic Cardiomyopathy?

    <p>Sarcomeric proteins</p> Signup and view all the answers

    Which cardiomyopathy is characterized by a severely thinned right ventricular wall?

    <p>Arrhythmogenic Right Ventricular Cardiomyopathy</p> Signup and view all the answers

    Which cardiomyopathy is associated with defective diastolic filling and ventricular outflow obstruction?

    <p>Hypertrophic Cardiomyopathy</p> Signup and view all the answers

    Which cardiomyopathy is characterized by a decrease in ventricular compliance and impaired ventricular filling during diastole?

    <p>Restrictive Cardiomyopathy</p> Signup and view all the answers

    Which cardiomyopathy is associated with a massive myocardial hypertrophy without ventricular dilation?

    <p>Hypertrophic Cardiomyopathy</p> Signup and view all the answers

    Which cardiomyopathy is characterized by a firm and noncompliant myocardium?

    <p>Restrictive Cardiomyopathy</p> Signup and view all the answers

    Which cardiomyopathy is associated with a thick-walled, heavy, and hypercontractile heart?

    <p>Hypertrophic Cardiomyopathy</p> Signup and view all the answers

    Which cardiomyopathy is the most common cause of sudden cardiac death and has right risded heart failure and rhythm disturbance?

    <p>Arrhythmogenic Right Ventricular Cardiomyopathy</p> Signup and view all the answers

    Which cardiomyopathy is associated with biatrial dilation?

    <p>Restrictive Cardiomyopathy</p> Signup and view all the answers

    What is the most common cause of restrictive cardiomyopathy worldwide?

    <p>Endomyocardial fibrosis</p> Signup and view all the answers

    Which clinical feature is commonly seen in hypertrophic cardiomyopathy?

    <p>All of the above</p> Signup and view all the answers

    Which gene mutation is associated with Arrhythmogenic Right Ventricular Cardiomyopathy?

    <p>Plakoglobin</p> Signup and view all the answers

    Which cardiomyopathy is typically associated with a family history of sudden death from heart problems?

    <p>Hypertrophic Cardiomyopathy</p> Signup and view all the answers

    Which type of cardiomyopathy is associated with ventricular outflow obstruction?

    <p>Hypertrophic Cardiomyopathy</p> Signup and view all the answers

    Study Notes

    Valvular Disease

    • Obstructive valvular disease is characterized by failure to open completely, impeding forward blood flow.
    • Regurgitation occurs primarily due to valve insufficiency, where valves fail to close properly, allowing backflow of blood.
    • Pressure overload leading to cardiac hypertrophy is typically seen in aortic stenosis.
    • The most common cause of acquired stenosis of aortic and mitral valves is age-related calcific degeneration.
    • Chronic Rheumatic Fever is characterized by fibrosis and scarring of heart valves, noted in the formation of "fish mouth" stenosis at the mitral valve.
    • The main cause of Rheumatic Fever is Group A Streptococcus infection, particularly following pharyngitis.
    • Bicuspid aortic valve is present in 1-2% of all live births, indicating a congenital condition.
    • Genetic mutations associated with bicuspid aortic valve often involve mutations in the NOTCH1 gene.
    • The aortic valve is positioned just above the left atrium, leading to significant anatomical relationships.
    • Myocardium beneath the endocardium appears a reddish-brown color due to richness in blood supply.

    Valvular Attachments and Characteristics

    • The mitral valve’s leaflet margins are attached to papillary muscles via chordae tendineae.
    • The aortic valve contains three cusps.
    • Tricuspid valve leaflets have a smooth and thin texture.
    • The valve similar to the mitral valve is known as the bicuspid valve.
    • In Rheumatic Fever, the mitral valve is affected in approximately 70% of cases.
    • Acquired stenosis of aortic and mitral valves is mainly due to calcification and degenerative changes.
    • Pancarditis in Rheumatic Fever primarily stems from the inflammatory response to streptococcal infection.

    Erythema Marginatum and Aschoff Bodies

    • Erythema marginatum presents as a serpiginous rash, often a feature of Rheumatic Fever.
    • Aschoff bodies consist primarily of T lymphocytes and macrophages, found in the heart tissue during Rheumatic Fever.
    • Scattered Aschoff bodies are prevalent in the context of Rheumatic heart disease.

    Infective Endocarditis

    • The mitral and aortic valves are most commonly infected in cases of infective endocarditis.
    • Clinical features of infective endocarditis can include fever, murmurs, petechiae, and embolic phenomena.
    • Microemboli associated with infective endocarditis typically consist of fragmented vegetation material that can lead to systemic embolization.
    • Vegetations in infective endocarditis are characterized by irregular, broad masses on valve surfaces.
    • In intravenous drug users, the tricuspid valve is frequently the target valve in cases of infective endocarditis.
    • Acute infective endocarditis involves highly virulent organisms attacking a previously normal valve, while subacute infective endocarditis affects an already abnormal valve.
    • Nonbacterial thrombotic endocarditis features sterile vegetations mainly located on either side of the valve leaflets.

    Cardiomyopathy Overview

    • Dilated cardiomyopathy is characterized by progressive cardiac dilation and contractile dysfunction accompanied by hypertrophy.
    • Acquired causes of dilated cardiomyopathy include ischemic heart disease and prolonged alcohol abuse.
    • The most common gene mutation linked with dilated cardiomyopathy involves mutations in the TTN gene.
    • Morphology of dilated cardiomyopathy often reveals enlarged ventricles with diminished systolic function.
    • Clinical features commonly associated with dilated cardiomyopathy include heart failure symptoms such as dyspnea and fatigue.

    Cardiomyopathy Specifics

    • Restrictive cardiomyopathy is most commonly caused by conditions like amyloidosis and fibrosis.
    • Hypertrophic cardiomyopathy is characterized by a genetic mutation affecting sarcomeric proteins, leading to thickened myocardium.
    • Arrhythmogenic right ventricular cardiomyopathy is associated with mutations in the desmosome proteins.
    • Ventricular outflow obstruction is commonly seen in cases of hypertrophic cardiomyopathy, leading to potential heart failure and arrhythmias.

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    Description

    Test your knowledge of heart anatomy and valves with this quiz! Identify the different characteristics of the aortic and tricuspid valves, and learn about their unique features such as cusps, chordae tendineae, and more. Perfect for medical students or anyone interested in cardiovascular health.

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