Valvular Heart Disease PDF
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This document provides an overview of valvular heart disease, including the basics of heart function, causes of valvular disease, and murmurs associated with different valve conditions.
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Valvular Heart Disease ○ There are 4 heart valves and each of them may be affected by stenosis or insufficiency (regurgitation). ○ Basics about the heart Normal heart tones, S1 and S2, are due to valve closures....
Valvular Heart Disease ○ There are 4 heart valves and each of them may be affected by stenosis or insufficiency (regurgitation). ○ Basics about the heart Normal heart tones, S1 and S2, are due to valve closures. Valves open and close based on pressure changes above and below the valves. When the pressure chamber above the valve is higher than below the valve, the valve opens. When the pressure drops in the chamber above the valve and the pressure is greater below the valve, the valve closes. Systolic: ejection, high pressure Diastolic: filling, low pressure Diastole is one-thirds longer than systole because it needs time to fill. Coronaries are perfused during diatole. Why do cardiac output and blood pressure drop with tachyarrhythmias? Less filling time leads to less cardiac output. ○ Causes of Valvular Disease Coronary Artery Disease, Ischemia, or Acute Myocardial Infarction Dilated cardiomyopathy Degeneration Bicuspid aortic valve (this is genetic) Rheumatic fever Infection Connective Tissue disease ○ Murmurs Murmurs of INSUFFICIENCY (regurgitation) occur when the valve is closed. Can be acute or chronic Murmurs of Stenosis occur when the valve isopen This will always be chronic, develops over time Never acute ○ Systolic Murmurs Lub….Shhhb….Dub Semilunar Valves are OPEN during systole Aortic Stenois or Pulmonic Stenosis AV Valves are CLOSED during systole Mitral Insuffciency ○ Will cause large, V waves on the pulmonary artery occlusion tracing if the patient has a pulmonary artery catheter. Tricuspid Insuffciency Ventricular-septal defect (VSD), is common with an acute MI and may result in a systoplic murmur. This is heard on the left sternal border, 5th intercostal space ○ Diastolic Murmurs Lub….Dub….Shhhb Semilunar Valves are CLOSED during diastole Aortic insufficiency (AI) Pulmonic Insuffciency (PI) AV Valves are OPEN during diastole Mitral stenosis is associated with atrial fibrillation dur to atrial enlargement that occurs overtime Tricuspid stenosis Murmur Summary ○ Mitral Insufficiency occurs when the mital valve is closed (Murmur occurs). When is the mitral valve closed? Systole Mitral Stenosis occurs when the mitral valve is open (Murmur occurs). When is the mitral valve open? Diastole Aortic Insufficiency occurs when the aortic valve is closed. When is the aortic valve closed? Diastole Aortic Stenosis occurs when the aortic valve is open. When is the aortic valve open? Systsole If you can picture what the aortic valve is doing, the pulmonic is doing the same. If you can picture when the mitral valve is doing, the tricuspid is doing the same. Does a murmur due to VSD happen during systole or diastole? During ejection or systole. ○ Murmurs associated with acture MI The mitral valve is attached to the left ventricle wall by the papillary muscles and the chordae tendineae. Myocardial ischemia or infarction can affect the mitral valce function and lead to acute mitral valve regurgitation. Papillary muscle dysfunction (Grade I or II), loudest at Apex/Mitral area Papillary muscle rupture (Grade V or VI), loudest at the apex/mitral area. This is a SURGICAL EMERGENCY! Ventriculat septal defect Sternal Border, 5th intercostal space.
