THERAPEUTICS EX3 L(?) (VALVULAR HEART DISEASE) (MIRANDA)

2 types of valves within the heart?

Semilunar valve

Atrioventricular

2 semilunar valves?

Aortic and pulmonary

2 atrioventricular valves

Mitral and tricuspid

2 categories of valve function?

Stenosis

Regurgitation

How do we diagnose valvular heart disease? (two tests)

ECHO

MRI

T/F: Aortic stenosis is the most common type of valvular heart disease.

True

Surgical treatment for aortic stenosis?

Valve replacement recommended in select patients

When do we treat hypertension in aortic stenosis?

In patients at risk for developing AS (stage A) and in patients with asymptomatic AS (stage B and C) should be treated according to guidelines, started at a low dose and gradually titrated upward (Class I, LOE B)

About when does aortic stenosis manifest?

60 years of age

Aortic regurgitation is caused by what? (two)

1. Abnormal valve leaflets

2. Dilated root of the aorta pulling normal leaflets apart

Surgical aortic regurgitation treatment?

Valve replacement in select patients

When should we manage hypertension in aortic regurgitation?

Hypertension should be managed in patients with chronic AR

Mitral stenosis is almost exclusively caused by what

Rheumatic heart disease

Symptoms of mitral stenosis mimic what?

Left or right-sided heart failure

T/F: Patients with mitral stenosis are at an increased risk for developing AFib and pulmonary HTN.

True

Causes of mitral regurgitation?

Mitral valve prolapse (MVP)

Distorted papillary muscles

Dilation of left ventricles pulling apart mitral apparatus

Treatment options for mitral regurgitation?

May consider medical therapy for systolic dysfunction in symptomatic patients with chronic primary MR (stage D) LVEF < 60% in whom surgery is not contemplated otherwise surgery

Features of mechanical valves?

Durable

Composed of plastic, metal, or carbon alloys and classified according to structure

Very thrombogenic - require lifelong antithrombotic therapy

Features of bioprosthetic valves?

Less durable (10-15 years)

Porcine or bovine

Less thrombogenic - does not require lifelong antithrombotic therapy