1. Valves of the Heart

1.1 Atrioventricular Valves

• Tricuspid Valve

  • Separates the right atrium from the right ventricle.

• Mitral Valve

  • Separates the left atrium from the left ventricle.

1.2 Semilunar Valves

• Pulmonic Valve

  • Located between the right ventricle and the pulmonary artery.

• Aortic Valve

  • Located between the left ventricle and the aorta.

1.3 Chordae Tendineae

• Nondescendable fibrous strands that anchor the valve leaflets to the papillary muscles of the ventricle.

• Function: Prevents inversion or prolapse of the valve leaflets during ventricular contraction (systole).

2. Valve Dysfunction

2.1 Regurgitation

• Occurs when a valve does not close completely, allowing blood to flow backward through the valve.

2.2 Stenosis

• Occurs when a valve does not open completely, reducing blood flow through the valve.

• Example: Similar to blood flow reduction caused by arterial plaque.

2.3 Prolapse

• Stretching of the valve leaflets into the atrium during systole, which can affect valve function.

3. Mitral Valve Prolapse

• A lifelong disorder often presenting with no symptoms.

• Rarely progresses to severe complications or death.

• Symptoms (if present): fatigue, shortness of breath, dizziness, palpitations.

• Treatment: Control symptoms, monitor for heart failure, possible valve repair/replacement.

4. Murmurs and Diagnosis

• Murmur: A loud, blowing sound heard at the apex of the heart due to abnormal blood flow.

• Patients may exhibit a regular or irregular pulse; diagnosed via echocardiogram.

• Follow-up frequency: Every 6 months if symptomatic, every 2-5 years if asymptomatic.

5. Cardiac Surgery & Management

5.1 Valve Replacement Types

• Mechanical Valves: More durable, used in younger patients or those with specific conditions like kidney injury or endocarditis.

• Tissue Valves:

  • Bioprosthesis: From animal tissue (e.g., pig).

  • Homograft: From cadaveric tissue.

  • Autograft: Patient's own tissue used.

• Risks of rejection and infection are associated with tissue valves.

5.2 Post-Operative Care

• Patients go to ICU for monitoring and recovery.

• Close follow-up to manage infection risk post-surgery.

• Medications to treat arrhythmias and manage symptoms.

6. Infective Endocarditis

• Infection of the heart valves usually seen in patients with prosthetic valves or prior cardiac surgery.

• Symptoms: Fever, weight loss, clusters of petechiae, fatigue.

• Diagnosis: Blood cultures, echocardiogram to check for vegetative growth.

• Treatment: Long-term antibiotics (IV) and close monitoring.

7. Myocarditis and Pericarditis

7.1 Myocarditis

• Inflammation of the myocardium, which can lead to cardiomyopathy and heart failure.

• Symptoms: flu-like symptoms, chest discomfort.

• Diagnosis: Endomyocardial biopsy or MRI.

• Management: Rest and limit activities in younger patients.

7.2 Pericarditis

• Inflammation of the pericardial sac.

• Common symptoms include chest pain that worsens with inspiration or when lying down.

• Diagnosis may include echocardiogram, elevated white blood cell counts, and physical exam.

• Treatment: Pain management, patient education on distinguishing from heart attack symptoms.