Podcast
Questions and Answers
What percentage of patients infected with streptococci develop rheumatic heart disease?
What percentage of patients infected with streptococci develop rheumatic heart disease?
Which of the following complications is associated with rheumatic heart disease?
Which of the following complications is associated with rheumatic heart disease?
What role do CD4+ T cells play in the context described?
What role do CD4+ T cells play in the context described?
What is suggested to influence susceptibility to rheumatic fever?
What is suggested to influence susceptibility to rheumatic fever?
Signup and view all the answers
What is a possible consequence of acute rheumatic fever on the heart's chordae tendineae?
What is a possible consequence of acute rheumatic fever on the heart's chordae tendineae?
Signup and view all the answers
Which part of the heart is primarily affected by rheumatic heart disease?
Which part of the heart is primarily affected by rheumatic heart disease?
Signup and view all the answers
What percentage of cases affect the aortic valve in rheumatic heart disease?
What percentage of cases affect the aortic valve in rheumatic heart disease?
Signup and view all the answers
Which condition is NOT typically associated with rheumatic fever?
Which condition is NOT typically associated with rheumatic fever?
Signup and view all the answers
What is the primary cause of myxomatous degeneration of the mitral valve?
What is the primary cause of myxomatous degeneration of the mitral valve?
Signup and view all the answers
Which group of bacteria is associated with triggering rheumatic fever?
Which group of bacteria is associated with triggering rheumatic fever?
Signup and view all the answers
What characterizes the mitral valve in cases of myxomatous degeneration?
What characterizes the mitral valve in cases of myxomatous degeneration?
Signup and view all the answers
What condition is a direct consequence of rheumatic fever?
What condition is a direct consequence of rheumatic fever?
Signup and view all the answers
What is the typical incidence range of rheumatic fever affecting adults?
What is the typical incidence range of rheumatic fever affecting adults?
Signup and view all the answers
In myxomatous mitral valve disease, during which phase does the mitral leaflets prolapse into the left atrium?
In myxomatous mitral valve disease, during which phase does the mitral leaflets prolapse into the left atrium?
Signup and view all the answers
What is the underlying mechanism of primary mitral valve prolapse?
What is the underlying mechanism of primary mitral valve prolapse?
Signup and view all the answers
What type of disease is rheumatic fever categorized as?
What type of disease is rheumatic fever categorized as?
Signup and view all the answers
What is the primary purpose of microbiome analysis in diagnosing certain conditions?
What is the primary purpose of microbiome analysis in diagnosing certain conditions?
Signup and view all the answers
Which factor is critical in assessing the prognosis of an infection?
Which factor is critical in assessing the prognosis of an infection?
Signup and view all the answers
What type of quiz is typically utilized to identify positive blood cultures?
What type of quiz is typically utilized to identify positive blood cultures?
Signup and view all the answers
Which condition may likely result from a severe microbiome imbalance?
Which condition may likely result from a severe microbiome imbalance?
Signup and view all the answers
What diagnostic method is applied to examine the effect of microbiomes on health?
What diagnostic method is applied to examine the effect of microbiomes on health?
Signup and view all the answers
Which of the following represents a complication that may affect diagnosis accuracy?
Which of the following represents a complication that may affect diagnosis accuracy?
Signup and view all the answers
What characterizes acute endocarditis compared to subacute endocarditis?
What characterizes acute endocarditis compared to subacute endocarditis?
Signup and view all the answers
Which group is most frequently associated with infections affecting the tricuspid valve?
Which group is most frequently associated with infections affecting the tricuspid valve?
Signup and view all the answers
What is a common outcome of vegetations formed during acute endocarditis?
What is a common outcome of vegetations formed during acute endocarditis?
Signup and view all the answers
Which statement regarding the nature of infective endocarditis is accurate?
Which statement regarding the nature of infective endocarditis is accurate?
Signup and view all the answers
What complication can arise from morbid vegetation in infective endocarditis?
What complication can arise from morbid vegetation in infective endocarditis?
Signup and view all the answers
In terms of valves affected, which is typically more common in non-drug users?
In terms of valves affected, which is typically more common in non-drug users?
Signup and view all the answers
Which characteristic is not commonly associated with virulent infections in endocarditis?
Which characteristic is not commonly associated with virulent infections in endocarditis?
Signup and view all the answers
Which of the following correctly describes subacute endocarditis?
Which of the following correctly describes subacute endocarditis?
Signup and view all the answers
What is the primary characteristic associated with pericarditis, as mentioned in the text?
What is the primary characteristic associated with pericarditis, as mentioned in the text?
Signup and view all the answers
Which of the following statements is NOT supported by the provided text?
Which of the following statements is NOT supported by the provided text?
Signup and view all the answers
Based on the text, what is the most common age group affected by acute rheumatic fever?
Based on the text, what is the most common age group affected by acute rheumatic fever?
Signup and view all the answers
What is the primary pathological hallmark of myocarditis, as described in the text?
What is the primary pathological hallmark of myocarditis, as described in the text?
Signup and view all the answers
Which of the following accurately describes the text's reference to "Aschoff bodies"?
Which of the following accurately describes the text's reference to "Aschoff bodies"?
Signup and view all the answers
Which of the following statements accurately reflects the text's explanation of the development of acute cardiac involvement?
Which of the following statements accurately reflects the text's explanation of the development of acute cardiac involvement?
Signup and view all the answers
Acute rheumatic fever is typically characterized by a gradual onset of cardiac involvement.
Acute rheumatic fever is typically characterized by a gradual onset of cardiac involvement.
Signup and view all the answers
The presence of Aschoff bodies is diagnostic for rheumatic heart disease.
The presence of Aschoff bodies is diagnostic for rheumatic heart disease.
Signup and view all the answers
Myxomatous degeneration of the mitral valve is a consequence of acute rheumatic fever.
Myxomatous degeneration of the mitral valve is a consequence of acute rheumatic fever.
Signup and view all the answers
Rheumatic fever can occur at any age, but it is most commonly seen in adults.
Rheumatic fever can occur at any age, but it is most commonly seen in adults.
Signup and view all the answers
The aortic valve is the most commonly affected valve in rheumatic heart disease.
The aortic valve is the most commonly affected valve in rheumatic heart disease.
Signup and view all the answers
Aschoff bodies are typically found in the myocardium of patients with rheumatic fever.
Aschoff bodies are typically found in the myocardium of patients with rheumatic fever.
Signup and view all the answers
Marfan syndrome is the most common cause of acquired valvular disease.
Marfan syndrome is the most common cause of acquired valvular disease.
Signup and view all the answers
The mitral valve is not typically affected by rheumatic heart disease.
The mitral valve is not typically affected by rheumatic heart disease.
Signup and view all the answers
Antibodies against M proteins cross-react with proteins found in the myocardium.
Antibodies against M proteins cross-react with proteins found in the myocardium.
Signup and view all the answers
The chordae tendineae are not affected in rheumatic heart disease.
The chordae tendineae are not affected in rheumatic heart disease.
Signup and view all the answers
Macrophages are not involved in the pathology of rheumatic heart disease.
Macrophages are not involved in the pathology of rheumatic heart disease.
Signup and view all the answers
Rheumatic fever is not associated with valvular disease.
Rheumatic fever is not associated with valvular disease.
Signup and view all the answers
The aortic valve is the most commonly affected valve in rheumatic heart disease.
The aortic valve is the most commonly affected valve in rheumatic heart disease.
Signup and view all the answers
Rheumatic heart disease only affects the valves of the heart.
Rheumatic heart disease only affects the valves of the heart.
Signup and view all the answers
Nonbacterial Thrombotic Endocarditis is characterized by the deposition of small, serous, and nondesstructive thrombotic masses on cardiac valves.
Nonbacterial Thrombotic Endocarditis is characterized by the deposition of small, serous, and nondesstructive thrombotic masses on cardiac valves.
Signup and view all the answers
Previous valvular damage is a prerequisite for the development of Nonbacterial Thrombotic Endocarditis.
Previous valvular damage is a prerequisite for the development of Nonbacterial Thrombotic Endocarditis.
Signup and view all the answers
The masses on cardiac valves in Nonbacterial Thrombotic Endocarditis are typically larger than 5 mm in size.
The masses on cardiac valves in Nonbacterial Thrombotic Endocarditis are typically larger than 5 mm in size.
Signup and view all the answers
Nonbacterial Thrombotic Endocarditis can occur on any valve in the heart.
Nonbacterial Thrombotic Endocarditis can occur on any valve in the heart.
Signup and view all the answers
The thrombotic masses in Nonbacterial Thrombotic Endocarditis are typically formed on top of pre-existing valvular lesions.
The thrombotic masses in Nonbacterial Thrombotic Endocarditis are typically formed on top of pre-existing valvular lesions.
Signup and view all the answers
Nonbacterial Thrombotic Endocarditis is a common complication of acute rheumatic fever.
Nonbacterial Thrombotic Endocarditis is a common complication of acute rheumatic fever.
Signup and view all the answers
Rheumatic heart disease primarily impacts the aortic valve, leading to stenosis.
Rheumatic heart disease primarily impacts the aortic valve, leading to stenosis.
Signup and view all the answers
Fibrous thickening and fusion of the chordae tendineae are hallmarks of previous rheumatic valvulitis episodes.
Fibrous thickening and fusion of the chordae tendineae are hallmarks of previous rheumatic valvulitis episodes.
Signup and view all the answers
The mitral valve leaflets are typically unaffected by rheumatic heart disease, maintaining their normal structure.
The mitral valve leaflets are typically unaffected by rheumatic heart disease, maintaining their normal structure.
Signup and view all the answers
The presence of small vegetations (verrucae) along the line of closure of the mitral valve leaflet is a characteristic of rheumatic heart disease.
The presence of small vegetations (verrucae) along the line of closure of the mitral valve leaflet is a characteristic of rheumatic heart disease.
Signup and view all the answers
Left atrial dilation, as seen from above the valve, is a common finding associated with mitral stenosis caused by rheumatic heart disease.
Left atrial dilation, as seen from above the valve, is a common finding associated with mitral stenosis caused by rheumatic heart disease.
Signup and view all the answers
Neovascularization is a characteristic feature observed in rheumatic mitral valve disease, reflecting an inflammatory response.
Neovascularization is a characteristic feature observed in rheumatic mitral valve disease, reflecting an inflammatory response.
Signup and view all the answers
The development of rheumatic heart disease is directly linked to the presence of antibodies against streptococcal antigens, such as streptolysin O.
The development of rheumatic heart disease is directly linked to the presence of antibodies against streptococcal antigens, such as streptolysin O.
Signup and view all the answers
Rheumatic heart disease primarily affects the mitral valve and, less commonly, the aortic valve, but never the tricuspid valve.
Rheumatic heart disease primarily affects the mitral valve and, less commonly, the aortic valve, but never the tricuspid valve.
Signup and view all the answers
Infective endocarditis is solely caused by bacterial infections in patients without any predisposing factors.
Infective endocarditis is solely caused by bacterial infections in patients without any predisposing factors.
Signup and view all the answers
The presence of vegetations in infective endocarditis primarily consists of fibrin, platelets, and microorganisms.
The presence of vegetations in infective endocarditis primarily consists of fibrin, platelets, and microorganisms.
Signup and view all the answers
Infective endocarditis can arise from surgical procedures that introduce contaminants into the bloodstream.
Infective endocarditis can arise from surgical procedures that introduce contaminants into the bloodstream.
Signup and view all the answers
Aneurysms may be a result of acute endocarditis due to direct damage to the vascular structures.
Aneurysms may be a result of acute endocarditis due to direct damage to the vascular structures.
Signup and view all the answers
Only intravenous drug users are at risk for developing infective endocarditis.
Only intravenous drug users are at risk for developing infective endocarditis.
Signup and view all the answers
Infective endocarditis is characterized by the formation of large, destructively bulky vegetations on heart valves.
Infective endocarditis is characterized by the formation of large, destructively bulky vegetations on heart valves.
Signup and view all the answers
Antibiotic prophylaxis is not recommended for patients with predisposing factors to infective endocarditis.
Antibiotic prophylaxis is not recommended for patients with predisposing factors to infective endocarditis.
Signup and view all the answers
Microbial infections of heart valves in infective endocarditis only affect the left side of the heart.
Microbial infections of heart valves in infective endocarditis only affect the left side of the heart.
Signup and view all the answers
What is the primary cardiac manifestation of Marfan syndrome?
What is the primary cardiac manifestation of Marfan syndrome?
Signup and view all the answers
What is the characteristic of the mitral valve in Marfan syndrome?
What is the characteristic of the mitral valve in Marfan syndrome?
Signup and view all the answers
What is the role of antibodies against M proteins in rheumatic heart disease?
What is the role of antibodies against M proteins in rheumatic heart disease?
Signup and view all the answers
What is the characteristic of the affected myocardium in rheumatic heart disease?
What is the characteristic of the affected myocardium in rheumatic heart disease?
Signup and view all the answers
What is the primary cause of myxomatous degeneration of the mitral valve?
What is the primary cause of myxomatous degeneration of the mitral valve?
Signup and view all the answers
What is the typical histopathological finding in rheumatic heart disease?
What is the typical histopathological finding in rheumatic heart disease?
Signup and view all the answers
What is the primary mechanism of cardiac injury in rheumatic heart disease?
What is the primary mechanism of cardiac injury in rheumatic heart disease?
Signup and view all the answers
What is the characteristic of the chordae tendineae in rheumatic heart disease?
What is the characteristic of the chordae tendineae in rheumatic heart disease?
Signup and view all the answers
What is the characteristic feature of the mitral valve leaflet in rheumatic heart disease, as shown in the figure (D)?
What is the characteristic feature of the mitral valve leaflet in rheumatic heart disease, as shown in the figure (D)?
Signup and view all the answers
What is the effect of previous episodes of rheumatic valvulitis on the chordae tendineae?
What is the effect of previous episodes of rheumatic valvulitis on the chordae tendineae?
Signup and view all the answers
What is the characteristic feature of the mitral valve in cases of rheumatic heart disease, as shown in the figure (C)?
What is the characteristic feature of the mitral valve in cases of rheumatic heart disease, as shown in the figure (C)?
Signup and view all the answers
What is the underlying mechanism of antibody-mediated heart damage in rheumatic heart disease?
What is the underlying mechanism of antibody-mediated heart damage in rheumatic heart disease?
Signup and view all the answers
What is the characteristic feature of the aortic valve in cases of rheumatic heart disease, as shown in the figure (E)?
What is the characteristic feature of the aortic valve in cases of rheumatic heart disease, as shown in the figure (E)?
Signup and view all the answers
What is the effect of rheumatic fever on the heart's chordae tendineae?
What is the effect of rheumatic fever on the heart's chordae tendineae?
Signup and view all the answers
What is the characteristic feature of the left atrium in cases of rheumatic heart disease, as shown in the figure (C)?
What is the characteristic feature of the left atrium in cases of rheumatic heart disease, as shown in the figure (C)?
Signup and view all the answers
What is the role of DNase in the context of streptococcal infections?
What is the role of DNase in the context of streptococcal infections?
Signup and view all the answers
What is the underlying immune response mechanism that leads to the development of rheumatic heart disease?
What is the underlying immune response mechanism that leads to the development of rheumatic heart disease?
Signup and view all the answers
How does acute rheumatic fever affect the morphology of the heart's mitral valve?
How does acute rheumatic fever affect the morphology of the heart's mitral valve?
Signup and view all the answers
What is the relationship between rheumatic fever and the development of valve disease?
What is the relationship between rheumatic fever and the development of valve disease?
Signup and view all the answers
What is the significance of fibrosis in the context of rheumatic heart disease?
What is the significance of fibrosis in the context of rheumatic heart disease?
Signup and view all the answers
How does the immune response to streptococcal infection contribute to the development of rheumatic heart disease?
How does the immune response to streptococcal infection contribute to the development of rheumatic heart disease?
Signup and view all the answers
What is the impact of rheumatic heart disease on the heart's chordae tendineae?
What is the impact of rheumatic heart disease on the heart's chordae tendineae?
Signup and view all the answers
What is the significance of susceptibility to rheumatic fever in the context of genetic variation?
What is the significance of susceptibility to rheumatic fever in the context of genetic variation?
Signup and view all the answers
What is the relationship between rheumatic heart disease and the development of severe mitral stenosis?
What is the relationship between rheumatic heart disease and the development of severe mitral stenosis?
Signup and view all the answers
What are the main causes of increased susceptibility to bacterial infections in endocarditis?
What are the main causes of increased susceptibility to bacterial infections in endocarditis?
Signup and view all the answers
Describe the role of Streptococcus viridans in endocarditis.
Describe the role of Streptococcus viridans in endocarditis.
Signup and view all the answers
What percentage of endocarditis cases is associated with acute rheumatic fever, and how does it lead to valve issues?
What percentage of endocarditis cases is associated with acute rheumatic fever, and how does it lead to valve issues?
Signup and view all the answers
What clinical features would you expect to see in a patient with endocarditis?
What clinical features would you expect to see in a patient with endocarditis?
Signup and view all the answers
How does infective endocarditis generally present itself, and what factors affect its outcomes?
How does infective endocarditis generally present itself, and what factors affect its outcomes?
Signup and view all the answers
What are the risks associated with intravenous drug abuse and its relation to endocarditis?
What are the risks associated with intravenous drug abuse and its relation to endocarditis?
Signup and view all the answers
Identify the potential complications of myocarditis as stated in the content.
Identify the potential complications of myocarditis as stated in the content.
Signup and view all the answers
Explain the significance of prior streptococcal infections in relation to endocarditis.
Explain the significance of prior streptococcal infections in relation to endocarditis.
Signup and view all the answers
Explain the relationship between bacterial infections, particularly those caused by Staphylococcus aureus, and the development of infective endocarditis. Discuss the potential complications that can arise from this condition.
Explain the relationship between bacterial infections, particularly those caused by Staphylococcus aureus, and the development of infective endocarditis. Discuss the potential complications that can arise from this condition.
Signup and view all the answers
What are the key differences between acute and subacute endocarditis? Discuss the potential causes, clinical presentation, and likely outcomes for each type.
What are the key differences between acute and subacute endocarditis? Discuss the potential causes, clinical presentation, and likely outcomes for each type.
Signup and view all the answers
Explain how rheumatic fever can affect the heart valves. What is the mechanism by which this happens, and what are the potential long-term consequences of such damage?
Explain how rheumatic fever can affect the heart valves. What is the mechanism by which this happens, and what are the potential long-term consequences of such damage?
Signup and view all the answers
What are the potential consequences of infective endocarditis on the heart, and how can these consequences impact the overall health of the individual?
What are the potential consequences of infective endocarditis on the heart, and how can these consequences impact the overall health of the individual?
Signup and view all the answers
Explain the connection between bacterial infections and the development of rheumatic fever. Discuss the importance of early diagnosis and treatment of bacterial infections in preventing this complication.
Explain the connection between bacterial infections and the development of rheumatic fever. Discuss the importance of early diagnosis and treatment of bacterial infections in preventing this complication.
Signup and view all the answers
Discuss the mechanism by which infective endocarditis can lead to the formation of vegetations on the heart valves. What are the potential consequences of these vegetations?
Discuss the mechanism by which infective endocarditis can lead to the formation of vegetations on the heart valves. What are the potential consequences of these vegetations?
Signup and view all the answers
Describe the process by which the bacteria Staphylococcus aureus can cause infective endocarditis, highlighting the key steps involved in the infection process.
Describe the process by which the bacteria Staphylococcus aureus can cause infective endocarditis, highlighting the key steps involved in the infection process.
Signup and view all the answers
Explain the relationship between rheumatic heart disease and infective endocarditis. Are they distinct conditions, or are they related in some way? Discuss their similarities and differences.
Explain the relationship between rheumatic heart disease and infective endocarditis. Are they distinct conditions, or are they related in some way? Discuss their similarities and differences.
Signup and view all the answers
About 3% of patients infected with ______ develop rheumatic heart disease.
About 3% of patients infected with ______ develop rheumatic heart disease.
Signup and view all the answers
In acute rheumatic fever, there are ______ responses involving various tissues.
In acute rheumatic fever, there are ______ responses involving various tissues.
Signup and view all the answers
CD4+ T cells recognize ______ peptides and trigger inflammatory responses.
CD4+ T cells recognize ______ peptides and trigger inflammatory responses.
Signup and view all the answers
Rheumatic heart disease is characterized by ______ degeneration of the mitral valve.
Rheumatic heart disease is characterized by ______ degeneration of the mitral valve.
Signup and view all the answers
The ______ valve is primarily affected in rheumatic heart disease.
The ______ valve is primarily affected in rheumatic heart disease.
Signup and view all the answers
Fibrosis of the ______ valve leads to severe mitral stenosis.
Fibrosis of the ______ valve leads to severe mitral stenosis.
Signup and view all the answers
In rheumatic heart disease, the ______ tendineae may rupture, leading to severe mitral regurgitation.
In rheumatic heart disease, the ______ tendineae may rupture, leading to severe mitral regurgitation.
Signup and view all the answers
Rheumatic fever is associated with ______ valve disease in 95% of cases.
Rheumatic fever is associated with ______ valve disease in 95% of cases.
Signup and view all the answers
Acue cardac nvovemen may ead o one or more o e oowng: becomes daed owng o ______ overoad.
Acue cardac nvovemen may ead o one or more o e oowng: becomes daed owng o ______ overoad.
Signup and view all the answers
Percardts assocaed w a brnous ______
Percardts assocaed w a brnous ______
Signup and view all the answers
Myocardts n e orm o ______ Ascof bodes wn e
Myocardts n e orm o ______ Ascof bodes wn e
Signup and view all the answers
Acue reumac ever s mos common n c- ______
Acue reumac ever s mos common n c- ______
Signup and view all the answers
nersve connecve ssue; paognomonc Ascof ______
nersve connecve ssue; paognomonc Ascof ______
Signup and view all the answers
Two o ree weeks ater ______
Two o ree weeks ater ______
Signup and view all the answers
Mur _______ are present in 90% of patients with rheumatic heart disease.
Mur _______ are present in 90% of patients with rheumatic heart disease.
Signup and view all the answers
The prognosis of an infection depends on _______ organ system and the extent of the disease.
The prognosis of an infection depends on _______ organ system and the extent of the disease.
Signup and view all the answers
Rheumatic fever is categorized as a type of _______ disease.
Rheumatic fever is categorized as a type of _______ disease.
Signup and view all the answers
In rheumatic heart disease, the _______ valve is primarily affected.
In rheumatic heart disease, the _______ valve is primarily affected.
Signup and view all the answers
The primary purpose of _______ analysis is to diagnose certain conditions.
The primary purpose of _______ analysis is to diagnose certain conditions.
Signup and view all the answers
A _______ imbalance may result in a severe infection.
A _______ imbalance may result in a severe infection.
Signup and view all the answers
Adverse sequelae of rheumatic fever include ______ due to wrapping of antigen-antibody complexes in glomeruli.
Adverse sequelae of rheumatic fever include ______ due to wrapping of antigen-antibody complexes in glomeruli.
Signup and view all the answers
Other adverse sequelae include ______ from invasion into the underlying myocardium and conduction system, and systemic embolization.
Other adverse sequelae include ______ from invasion into the underlying myocardium and conduction system, and systemic embolization.
Signup and view all the answers
Unreacted, ineffective endocarditis generally is ______.
Unreacted, ineffective endocarditis generally is ______.
Signup and view all the answers
Appropriate long-term ______ therapy and/or valve replacement may reduce mortality rates.
Appropriate long-term ______ therapy and/or valve replacement may reduce mortality rates.
Signup and view all the answers
For infections involving low-virulence organisms, such as S. viridans, the cure rate is ______%.
For infections involving low-virulence organisms, such as S. viridans, the cure rate is ______%.
Signup and view all the answers
For S. aureus infections, cure rates range from ______ to 90%.
For S. aureus infections, cure rates range from ______ to 90%.
Signup and view all the answers
However, with infections due to aerobic gram-negative bacteria or fungi, patients ______ succumb.
However, with infections due to aerobic gram-negative bacteria or fungi, patients ______ succumb.
Signup and view all the answers
Rheumatic heart disease is categorized as a ______ disease.
Rheumatic heart disease is categorized as a ______ disease.
Signup and view all the answers
These diseases are characterized by cardiac myocyte dysfunction that may be confined to the myocardium (primary) or may be a ______ of a systemic disorder (secondary).
These diseases are characterized by cardiac myocyte dysfunction that may be confined to the myocardium (primary) or may be a ______ of a systemic disorder (secondary).
Signup and view all the answers
Included among the diverse diseases that lead to myocyte dysfunction are infectious, immunologic, metabolic, and ______ disorders.
Included among the diverse diseases that lead to myocyte dysfunction are infectious, immunologic, metabolic, and ______ disorders.
Signup and view all the answers
Those that are inflammatory in nature are generally considered forms of ______.
Those that are inflammatory in nature are generally considered forms of ______.
Signup and view all the answers
These diseases are characterized by changes in atrial and/or ventricular dilation and in ventricular wall ______.
These diseases are characterized by changes in atrial and/or ventricular dilation and in ventricular wall ______.
Signup and view all the answers
Genes that encode cytoskeletal proteins or proteins that link the sarcomere to the cytoskeleton are most commonly ______, typically by mutations that result in loss-of-function.
Genes that encode cytoskeletal proteins or proteins that link the sarcomere to the cytoskeleton are most commonly ______, typically by mutations that result in loss-of-function.
Signup and view all the answers
Dilated cardiomyopathy is considered hereditary in 20% to 50% of ______.
Dilated cardiomyopathy is considered hereditary in 20% to 50% of ______.
Signup and view all the answers
Mutations in over 50 genes have been implicated, usually with autosomal dominant ______.
Mutations in over 50 genes have been implicated, usually with autosomal dominant ______.
Signup and view all the answers
Ao, aorta; LA, left atrium; LV, left ______.
Ao, aorta; LA, left atrium; LV, left ______.
Signup and view all the answers
Match the following cardiac valve abnormalities with their descriptions:
Match the following cardiac valve abnormalities with their descriptions:
Signup and view all the answers
Match the following clinical features with their associated cardiac condition:
Match the following clinical features with their associated cardiac condition:
Signup and view all the answers
Match the following anatomical structures with their relevant descriptions:
Match the following anatomical structures with their relevant descriptions:
Signup and view all the answers
Match the following terms with their definitions:
Match the following terms with their definitions:
Signup and view all the answers
Match the following cardiac conditions with their primary characteristics:
Match the following cardiac conditions with their primary characteristics:
Signup and view all the answers
Match the following cardiac conditions with their effects on heart valves:
Match the following cardiac conditions with their effects on heart valves:
Signup and view all the answers
Match the following cardiac conditions with their underlying causes:
Match the following cardiac conditions with their underlying causes:
Signup and view all the answers
Match the following cardiac conditions with their complications:
Match the following cardiac conditions with their complications:
Signup and view all the answers
Match the following cardiac conditions with their treatment options:
Match the following cardiac conditions with their treatment options:
Signup and view all the answers
Match the following cardiac conditions with their characteristic lesions:
Match the following cardiac conditions with their characteristic lesions:
Signup and view all the answers
Match the following types of endocarditis with their characteristics:
Match the following types of endocarditis with their characteristics:
Signup and view all the answers
Match the following valve diseases with their characteristics:
Match the following valve diseases with their characteristics:
Signup and view all the answers
Match the following cardiac conditions with their age groups:
Match the following cardiac conditions with their age groups:
Signup and view all the answers
Match the following cardiac conditions with their effects on the heart:
Match the following cardiac conditions with their effects on the heart:
Signup and view all the answers
Match the following conditions with their effects on the heart:
Match the following conditions with their effects on the heart:
Signup and view all the answers
Match the following characteristics with the type of endocarditis:
Match the following characteristics with the type of endocarditis:
Signup and view all the answers
Match the following valve diseases with their underlying mechanisms:
Match the following valve diseases with their underlying mechanisms:
Signup and view all the answers
Match the following conditions with their associations:
Match the following conditions with their associations:
Signup and view all the answers
Match the following terms with their corresponding descriptions:
Match the following terms with their corresponding descriptions:
Signup and view all the answers
Match the following conditions with their corresponding effects on the heart:
Match the following conditions with their corresponding effects on the heart:
Signup and view all the answers
Match the following terms with their corresponding associations:
Match the following terms with their corresponding associations:
Signup and view all the answers
Match the following conditions with their corresponding characteristics:
Match the following conditions with their corresponding characteristics:
Signup and view all the answers
Match the following terms with their corresponding consequences:
Match the following terms with their corresponding consequences:
Signup and view all the answers
Match the following conditions with their corresponding effects on the mitral valve:
Match the following conditions with their corresponding effects on the mitral valve:
Signup and view all the answers
Match the following terms with their corresponding associations:
Match the following terms with their corresponding associations:
Signup and view all the answers
Match the following conditions with their corresponding characteristics:
Match the following conditions with their corresponding characteristics:
Signup and view all the answers
Match the following terms with their corresponding descriptions in the context of heart disease.
Match the following terms with their corresponding descriptions in the context of heart disease.
Signup and view all the answers
Match the following conditions with their primary cause.
Match the following conditions with their primary cause.
Signup and view all the answers
Match the following terms with their corresponding structural features.
Match the following terms with their corresponding structural features.
Signup and view all the answers
Match the following functional patterns with their primary characteristic.
Match the following functional patterns with their primary characteristic.
Signup and view all the answers
Match the following terms with their corresponding locations in the heart.
Match the following terms with their corresponding locations in the heart.
Signup and view all the answers
Match the following terms with their corresponding characteristics in the context of valvular heart disease.
Match the following terms with their corresponding characteristics in the context of valvular heart disease.
Signup and view all the answers
Study Notes
Rheumatic Heart Disease
- Cardiac manifestation of rheumatic fever, an acute immunologically mediated multisystem inflammatory disease.
- Occurs following infection with group A β-hemolytic streptococci.
- Characterized by myxomatous degeneration of one or both mitral valve leaflets, leading to "floppy" valves that prolapse during systole.
- Mitral valve prolapse is associated with valvular inflammation and scarring.
- Incidence of rheumatic fever varies between 0.5% to 2.4% in adults.
Myxomatous Mitral Valve Disease
- Primary mitral valve prolapse is a form of myxomatous degeneration due to inflammation and scarring.
- CD4+ T cells recognize streptococcal peptides, triggering cytokine-mediated inflammatory responses.
- In rheumatic heart disease, 95% of cases exhibit mitral valve dysfunction, and 25% may also involve the aortic valve.
- Genetic variants might influence susceptibility to rheumatic conditions.
Acute Rheumatic Fever and Valvular Injury
- Fibrosis of the mitral valve leads to commisural fusion and severe mitral stenosis.
- Accompanying acute rheumatic fever can involve inflammatory changes in other cardiac structures, including the chordae tendineae.
- Leads to dysfunction affecting multiple heart tissues.
Clinical Features
- Acute rheumatic fever primarily affects children but can also occur in adults, typically two to three weeks post-infection.
- Infective endocarditis can be classified into acute or subacute based on tempo and severity.
- Commonly involves the aortic and mitral valves, with vegetations observed in 90% of patients.
- Acute endocarditis is associated with virulent organisms, leading to destructive infections.
Diagnosis and Prognosis
- Diagnosis is confirmed through positive blood cultures and identification of vegetations via echocardiography.
- Prognosis largely depends on the infecting organism and extent of complications.
- Murmurs are prevalent in patients with infective endocarditis, often indicating valvular involvement.
Marfan Syndrome
- Most commonly causes acquired valvular disease.
- Resulting from mutation in the fibrillin gene.
- Morphological changes include ballooning (flodding) of affected mitral valves.
Pathogenesis
- Antibodies develop against M proteins from certain streptococcal strains.
- Characterized by enlarged, redundant, thickened, and rubbery mitral valves.
- Tendinous cords can become elongated and thinned, potentially affecting cardiac valves.
Histology and Clinical Features
- Histological examination reveals deposition of varying components and Fc receptor-bearing cells like macrophages.
- Acute cardiac involvement can manifest as pericarditis with fibrous exudate, myocarditis with scattered Aschoff bodies.
- Acute rheumatic fever frequently occurs in children but can also affect adults.
Vegetations and Valve Changes
- Small vegetations (verrucae) are noted along mitral valve leaflets.
- Previous rheumatic valvulitis can lead to fibrous thickening and fusion of chordae tendineae.
- Marked left atrial dilation is often observed.
Infective Endocarditis
- A microbial infection affecting heart valves and key in patients with predispositions like prosthetic heart valves.
- Characterized by vegetations made of thrombus and organisms, causing damage to cardiac tissues.
- Acute endocarditis displays bulky, potentially destructive vegetations rich in fibrin, neutrophils, and microorganisms.
Nonbacterial Thrombotic Endocarditis (NBTE)
- Characterized by small (1 to 5 mm) non-destructive thrombotic masses on cardiac valves.
- Occurs without previous valvular damage, often on previously normal valves.
Marfan Syndrome
- Most common cause of acquired valvular disease resulting from a mutation in the fibrillin gene.
- Characterized by ballooning or prolapse of affected mitral valves.
Pathogenesis
- Antibodies against M proteins from certain streptococcal strains react with proteins in the myocardium and pericardium.
- Enlarged, redundant, thick, and rubri coccal strains exhibit cross-reactivity with myocardial proteins, which may cause injury.
- Tendinous cords in the heart become elongated and thinned, potentially affecting cardiac valves.
Rheumatic Heart Disease
- Post-infectious condition where only about 3% of patients infected with streptococcus develop rheumatic valvular disease.
- Of those cases, 25% also involve the aortic valve, indicating a possible genetic susceptibility.
- Fibrosis of the mitral valve leads to fusion of commissures and severe mitral stenosis.
Inflammatory Response
- Acute rheumatic fever may show inflammatory changes affecting the chordae tendineae and other cardiac structures.
- Small vegetations (verrucae) occur along the closure line of the mitral valve leaflets.
- Previous episodes lead to fibrous thickening and fusion of chordae tendineae alongside left atrial dilation.
Clinical Manifestations
- Symptoms include pericarditis, cardiac dysfunction, mitral insufficiency, and signs of congestive heart failure.
- Increased susceptibility to bacterial infections due to damage to the endocardium.
- Less than 1% of patients die from acute rheumatic fever, although subsequent infections can increase risk.
Infective Endocarditis
- Often results from damaged or deformed cardiac structures, typically due to Streptococcus viridans.
- Staphylococcus aureus is associated with more severe cases due to heightened virulence.
- Chronic pulmonary venous congestion accounts for 10-20% of endocarditis cases.
Diagnosis and Risk Factors
- Diagnosis relies on evidence of previous streptococcal infections and present clinical signs.
- Risk factors for infective endocarditis include intravenous drug use and oral flora exposure.
- 10% of endocarditis cases show no identifiable organism, potentially leading to ineffective treatments.
Treatment Approaches
- Surgical intervention like mitral valvuloplasty or repair aims to restore normal function and reduce complications.
- Improved diagnostics and management strategies have significantly improved patient outcomes.
- Blood seeding with microbes is identified as a primary cause of infective endocarditis.
Myxomatous and Rheumatic Heart Disease
- Myxomatous (mucous) matter is associated with CD4+ T cells recognizing streptococcal peptides and host antigens.
- CD4+ T cells can also contribute to cytokine-mediated inflammatory responses in rheumatic heart disease.
- Approximately 3% of patients infected with streptococcus develop rheumatic heart disease; 95% of these cases involve valve dysfunction.
- 25% of patients with rheumatic heart disease may also have aortic valve involvement.
- Genetic variations may influence susceptibility to rheumatic heart disease.
- Fibrosis of the mitral valve leads to fusion of commissures and severe mitral stenosis.
Acute Rheumatic Fever
- Acute rheumatic fever involves inflammatory changes affecting the heart's three layers.
- Causes of acute cardiac injury include:
- Pericarditis associated with a fibrous exudate.
- Myocarditis resulting from scattered Aschoff bodies within the heart tissue.
Clinical Features of Acute Rheumatic Fever
- Most common in children, though adults can also be affected.
- Initial attacks can occur 2 to 3 weeks post-infection.
- Presence of Aschoff bodies is seen in 90% of patients.
- Symptoms of acute rheumatic fever include joint pains, carditis, and skin rashes.
- Diagnosis confirmed through positive blood cultures and echocardiography.
Prognosis and Complications
- Prognosis depends on the infecting organism and the extent of complications.
- Potential adverse sequelae include:
- Glomerulonephritis due to antigen-antibody complexes.
- Septicemia and arrhythmias from microbial invasion into the myocardium and conduction system.
- Systemic embolization can occur if untreated.
- Long-term antibiotic therapy and/or valve replacement can significantly reduce mortality rates.
- Cure rates for infections by low-virulence organisms like Streptococcus viridans are about 98%.
- Cure rates for Staphylococcus aureus infections range from 60% to 90%, with poorer outcomes for infections caused by aerobic gram-negative bacilli.
Cardiomyopathies and Myocarditis
- Diseases characterized by cardiac myocyte dysfunction can be due to genetic defects.
- Dilated cardiomyopathy is hereditary in 20% of cases and can involve the myocardium or be secondary to systemic disorders.
- Mutations affecting over 50 genes linked to various forms of dysfunction.
- Conditions linked to infectious, immunologic, metabolic, and genetic disorders are often inflammatory, resulting in loss of function.
Calcific Aortic Stenosis
- Associated with a congenitally bicuspid valve; one cusp shows partial fusion known as a raphe.
- Presents as calcification affecting the aortic valve and may lead to obstruction.
Mitral Calcification
- Features calcified nodules in the mitral valve annulus.
- Calcification can extend into the underlying myocardium, impacting cardiac function.
Clinical Features
- Patients often asymptomatic; conditions may be found incidentally during physical exams.
- Symptoms may include palpitations, dyspnea, and atypical chest pain.
- Auscultation can reveal a midsystolic click, potentially accompanied by a regurgitant murmur.
Septic Embolism
- Significant morbidity and mortality can occur despite adequate antibiotic therapy.
- Emboli originate from vegetations on affected valves, leading to septic infarcts and abscess formation.
Endocarditis Types
- Subacute Endocarditis: Involves low-virulence organisms, typically on previously abnormal valves, leading to chronic inflammation.
- Nonbacterial Thrombotic Endocarditis (NBTE): Characterized by small, sterile thrombotic masses on normal or previously damaged valves, not necessarily requiring prior valve damage for diagnosis.
NBTE Diagnosis
- Associated with diagnosed cardiomyopathy, leading to severe disease and potential heart failure.
- Iron overload conditions can exacerbate or mimic cardiomyopathy due to underlying heart damage and functional impairment.
Vegetations in NBTE
- Often minimal inflammation noted in affected heart valve cusps as seen in histological examination.
- Thrombus formation on valves appears loose and non-destructive, allowing for potential detachment.
Cardiomyopathies
- Classification by functional patterns such as dilated cardiomyopathy where ejection fraction considerably diminishes.
- Secondary causes of cardiac dysfunction must be differentiated from primary cardiomyopathy for appropriate management.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers the cardiac manifestations of rheumatic fever, an acute immunologically mediated multisystem inflammatory disease. It also includes questions on Myxomatous Mitral Valve Disease.