CRIM 2653 Lecture Notes - Lecture 34: Bicuspid Aortic Valve, Rheumatic Fever, Endocarditis
23 May 2020
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Document Summary
Etiology: congenital, most common = bicuspid aortic valve (containing 2 functional cusps instead of normal 3, acquired. Clinical manifestations: commonest = worldwide, but not in na/eu, rheumatic heart disease, damage, myocardium = acute effects, valvular = chronic and substantive effects. Outcome: depends on the valve involved, degree of impairment, and effectiveness of compensatory mechanisms. Incompetence: rheumatic (with fixed stenosis, rheumatic fever causing valvular inflammation and scarring, myxomatous change ( floppy , leaflets are floppy and prolapse = balloon back into the atrium during systole, annular dilatation, annular calcification. Valve lesions: sequelae, turbulent blood flow, effects, infection, heart failure. Infective endocarditis: virulent bug, rapid or acute infective endocarditis, death = days to weeks, low virulence bug. Valve replacement: bioprostheses or tissue valves, porcine, homograft, pericardial, [durameter, autografts, mechanical valves, ball in cage, disc = single leaflet, bileaflet, all need lifelong anticoagulation.
