Questions and Answers
Which type of calcific aortic stenosis is most commonly associated with congenital abnormalities?
What is the main cause of calcific aortic stenosis?
Which of the following clinical consequences can result from mitral valve calcification?
Among the following patients, who is most likely to develop senile calcific aortic stenosis?
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What is a potential consequence of nodular calcific deposits on the mitral valve?
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How does mitral valve calcification affect the opening of the valve leaflets?
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What is the common age group for patients with mitral valve calcification?
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Which of the following is not a consequence of mitral valve calcification?
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What is the primary cause of myxomatous mitral valve?
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Which complication is NOT associated with myxomatous mitral valve?
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What characterizes the sound associated with myxomatous mitral valve prolapse?
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Which demographic is more likely to be affected by myxomatous mitral valve?
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Myxomatous mitral valve is often associated with which connective tissue disorder?
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Which of the following is a common manifestation of acute rheumatic fever?
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Which type of endocarditis has a potential acute presentation?
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What is the primary immune response triggered by group A β-hemolytic streptococci in acute rheumatic fever?
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What percentage of congenital heart disease cases are attributed to ventricular septal defect (VSD)?
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Which factor is identified as a risk for developing ventricular septal defect (VSD)?
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What is one of the complications that can arise from large ventricular septal defects?
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What is the most common type of atrial septal defect (ASD)?
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In which demographic is atrial septal defect (ASD) most commonly diagnosed?
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What are the potential consequences of untreated atrial septal defects (ASD)?
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What is a key feature that distinguishes acyanotic congenital heart diseases from others?
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In ventricular septal defects (VSD), which portion is most commonly involved?
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What is a characteristic finding in Chronic Rheumatic Heart Disease in comparison to Acute Rheumatic Heart Disease?
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Which of the following is associated with non-infectious endocarditis?
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What type of lesion is primarily associated with Acute Rheumatic Heart Disease?
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Which statement correctly describes infectious endocarditis?
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Which structure is commonly affected during the chronic phase of rheumatic heart disease?
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What kind of vegetations is typically found in Acute Rheumatic Heart Disease?
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Which of the following is a manifestation of Chronic Rheumatic Heart Disease?
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What is the characteristic feature of Non-bacterial Thrombotic Endocarditis (NBTE)?
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Which type of endocarditis is characterized by vegetations that can develop quickly and may be life-threatening?
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In which condition is Libman-Sacks Endocarditis typically encountered?
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Which best describes a key characteristic of Non-infectious Endocarditis?
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What causes the deposition of thrombi in Libman-Sacks Endocarditis?
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Which of the following descriptions is true regarding Non-bacterial Thrombotic Endocarditis?
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Study Notes
Tetralogy of Fallot
- Characterized by four heart defects: ventricular septal defect (VSD), pulmonary stenosis, right ventricular hypertrophy, and over-riding aorta.
- Results in hypoxemia and cyanosis due to reduced oxygen-rich blood flow to the body.
Acyanotic Congenital Heart Diseases
- Involve left-to-right shunt malformations and obstructions; do not primarily cause cyanosis.
- Possible complications like Eisenmenger complex, where right-to-left shunting develops due to pulmonary hypertension.
- Common examples include:
- Ventricular Septal Defect (VSD)
- Atrial Septal Defect (ASD)
- Persistent Ductus Arteriosus (PDA)
- Coarctation of the Aorta
Ventricular Septal Defect (VSD)
- Most prevalent congenital heart defect, comprising about 30% of cases.
- Risk factors include maternal alcohol consumption.
- 30% occur in isolation; 70% associated with Tetralogy of Fallot.
- Types include:
- Membranous VSD (90%): most common.
- Muscular VSD: less common, often multiple, tends to close spontaneously.
- Small VSDs usually asymptomatic; likely to close by age 2.
- Large VSDs lead to symptoms like failure to thrive, difficulty breathing, and frequent infections.
- Can evolve into Eisenmenger complex if untreated.
Atrial Septal Defects (ASD)
- Represent around 8% of congenital heart diseases.
- Most common congenital anomaly discovered in adulthood.
- Three subtypes include ostium primum, ostium secundum, and sinus venosus ASD.
- Typically result in a left-to-right shunt but less problematic than VSDs.
- Approximately 10% may develop pulmonary hypertension and heart failure.
- Diagnosis usually made in early adulthood.
- Complications include paradoxical emboli.
Calcific Aortic Stenosis
- Results from degenerative valvular changes due to mechanical stress and fibrosis.
- Two forms exist:
- Congenital: arising from a bicuspid aortic valve, affecting about 2% of the population, leads to early fibrosis and calcification (40s-50s).
- Senile: usually seen in those aged 70 and older.
- Calcification is seen as nodular masses on the cusps’ outflow aspect.
Mitral Valve Calcification
- Common in elderly populations.
- Involves non-inflammatory deposits in the mitral annulus.
- Clinical consequences:
- Regurgitation due to inadequate contraction.
- Stenosis from ineffective leaflet opening.
- Potential arrhythmias from conduction disruptions.
- Thrombus formation leading to embolism.
- Rarely, may facilitate infective endocarditis.
Myxomatous Mitral Valve
- Also known as mitral valve prolapse.
- Characterized by an accumulation of ground substance in the valve tissue.
- Changes cause leaflets to become enlarged and floppy, leading to mitral regurgitation.
- Often asymptomatic but can lead to serious complications like infective endocarditis and arrhythmias.
- Associated with connective tissue disorders like Marfan syndrome.
Acute Rheumatic Fever
- An immunologically mediated inflammatory response following infections by group A β-hemolytic streptococci.
- Manifests as rheumatic heart disease, causing endocarditis, myocarditis, and pericarditis.
- Major and minor Jones criteria are utilized for diagnosis.
Chronic Rheumatic Heart Disease
- Results from the organization and fibrosis of lesions caused by acute rheumatic fever.
- Key differences from acute rheumatic heart disease include valve scarring, commissural fusion, and thickening of chordae tendineae.
Infectious Endocarditis
- Inflammation of the heart's inner lining, potentially leading to vegetations.
- Can be classified into:
- Infective endocarditis (acute and subacute).
- Non-infectious endocarditis, including non-bacterial thrombotic endocarditis and Libman-Sacks endocarditis.
Non-Bacterial Thrombotic Endocarditis (NBTE)
- Characterized by loose deposition of small sterile thrombi on heart valve leaflets.
- Often seen in debilitated patients—associated with hypercoagulability.
Libman-Sacks Endocarditis
- Involves sterile thrombi deposition related to systemic lupus erythematosus.
- Leads to localized inflammation, necrosis, thrombosis, and potential valve deformation.
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Description
Explore the complexities of Tetralogy of Fallot and other acyanotic congenital heart diseases. This quiz covers key malformations, complications, and examples including Ventricular Septal Defect and Atrial Septal Defect. Test your understanding of these heart conditions and their implications.
