Cardiac Abnormalities

Question 1

Stenotic

Answer 1

Doesn’t open fully

• Chamber upstream has to develop more systolic pressure in order to achieve a given flow thru valve
• Inc. “pressure” work (after load) –> hypertrophy

Question 2

Insufficient

Answer 2

Doesn’t close completely

• Regurgitant blood flow represents an additional volume that must be ejected to get sufficient forward flow
• Inc. “volume” work (stroke volume) -> chamber dilation

Question 3

What is aortic stenosis?

Answer 3

Aortic valve doesn’t open fully

-Inc. resistance to flow

Question 4

What are the signs of aortic stenosis?

Answer 4

• Significant pressure difference between LV and Aorta.
• Intraventricular pressure rises VERY HIGH during systole [150 mmHg] (KNOW)
• Aortic pressure is subnormal in systole
• Low pulse pressure
• High ejection velocity of blood leads to systolic murmur

Question 5

What does aortic stenosis cause?

Answer 5

• Cardiac muscle hypertrophy and increase left ventricular muscle mass
• Left axis deviation
• Very high ventricular after load!!

Question 6

What is mitral stenosis?

Answer 6

• Mitral valve doesn’t open fully

- Increased resistance to flow

Question 7

What are the signs of mitral stenosis?

Answer 7

• Left atrial pressure raised up around 40-45 mm Hg
• Pressure difference for more than a few mmHg across the mitral valve during diastole
• Elevated left atrial pressure
• Turbulent flow of blood leads to diastolic murmur

Question 8

What can mitral stenosis do to the heart?

Answer 8

Induce hypertrophy of left atrial muscle

Question 9

What is the physiological consequence of mitral stenosis?

Answer 9

• High left atrial and pulmonary capillary pressures
• High pulmonary capillary pressures (increased hydrostatic pressure) can cause pulmonary edema and interfere with gas exchange in lungs (symptoms: SOB/dyspnea)

Question 10

What is aortic insufficiency?

Answer 10

Leaflets of aortic valve do not seal –> blood regurgitates back into LV during diastole

Question 11

What are the characteristic signs of aortic insufficiency?

Answer 11

• Aortic pressure falls faster/farther than normal diastole
• Low diastolic pressure
• Large pulse pressure
• Ventricular EDV and EDP are higher than normal bc extra blood reenters the chamber
• Turbulent flow of blood reentering LV causes a diastolic murmur

Question 12

What is the physiological consequence of aortic insuffiency?

Answer 12

-Reduced ejection fraction, increased volume workload

Question 13

Often aortic valve is BOTH stenotic and insufficient & BOTH. . .

Answer 13

systolic & diastolic murmurs will be heard

Question 14

What is mitral regurgitation (insufficiency)?

Answer 14

Leaflets of mitral valve do not seal -> blood regurgitates back into left atrium during systole

Question 15

What are the characteristic signs of mitral regurgitation (insufficiency)?

Answer 15

• Left atrial pressure is abnormally high [50 mmHg]
• Left ventricular EDV and EDP increase
• Systolic murmur

Question 16

Wha tis the physiological consequence of mitral regurgitation?

Answer 16

Ejection fraction from L ventricle compromised, increased volume workload on LV

• May lead to pulmonary effects with SOB
• Prolapse is most common form –> valve leaflets evert into L atrium during systole

Question 17

Tachycardia

Answer 17

> 100 bpm

Question 18

Bradycardia