valvular heart disease. what is valvular heart disease?

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Valvular Heart DISEASE

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Page 1: Valvular Heart DISEASE. What is Valvular Heart Disease?

Valvular Heart DISEASE

Page 2: Valvular Heart DISEASE. What is Valvular Heart Disease?
Page 3: Valvular Heart DISEASE. What is Valvular Heart Disease?

What is Valvular Heart Disease?

Page 4: Valvular Heart DISEASE. What is Valvular Heart Disease?

What Are the Types of Valve Disease?

• There are several types of valvular heart disease, include:

• 1)Valvular stenosis: When a valve opening is smaller than normal

• 2)Valvular Insufficiency/REGURGITATION: occurs when a valve does not close tightly, thus allowing blood to leak backwards.

• Both valvular diseases can involve all four valves.

Page 5: Valvular Heart DISEASE. What is Valvular Heart Disease?

Types

• Mitral Stenosis• Mitral Regurgitation• Aortic Stenosis• Aortic regurgitation• Tricuspid valve is affected infrequently

– Tricuspid stenosis – causes Rt HF– Tricuspid regurgitation

• Pulmonary valve disease

Page 6: Valvular Heart DISEASE. What is Valvular Heart Disease?

• Congenital : mostly affect the aortic or pulmonic valve ,

• Acquired :.

• Other Acquired causes?• Rheumatic fever

• Infective endocarditis

• Coronary artery disease

• Heart attack

• Cardiomyopathy (heart muscle disease)

• Syphilis .

• Hypertension .

• Aortic aneurysms .

• Connective tissue diseases

What Causes Valvular Disease?

Page 7: Valvular Heart DISEASE. What is Valvular Heart Disease?

Rheumatic Heart Disease

• Inflammatory process that may affect the myocardium, pericardium and or endocardium

• Usually results in distortion and scarring of the valves

• Caused by a type 2 inflammatory reaction secondary to sore throat caused by a bacteria called S.pyogenes

Page 8: Valvular Heart DISEASE. What is Valvular Heart Disease?

Rheumatic Heart Disease, cont.– Prior history of

rheumatic fever– General malaise– Pain – may or may

not be present

– – Murmurs– Dyspnea– polyarthritis

Page 9: Valvular Heart DISEASE. What is Valvular Heart Disease?

Infective endocarditis • Infection of heart

valves • Commonly bacterial • Results in damage

to valve structure giving rise to senosis or regurgitation

Page 10: Valvular Heart DISEASE. What is Valvular Heart Disease?

Mitral Stenosis

• Usually results from rheumatic carditis• Is a thickening by fibrosis or calcification• Can be caused by tumors, calcium and thrombus • Valve leaflets fuse• These narrows the opening and prevents normal blood

flow from the LA to the LV• LA pressure increases, left atrium dilates, PAP

increases, and the RV hypertrophies• Pulmonary congestion and right sided heart failure

occurs• Followed by decreased preload and CO decreases

Page 11: Valvular Heart DISEASE. What is Valvular Heart Disease?
Page 12: Valvular Heart DISEASE. What is Valvular Heart Disease?

Mitral Stenosis, cont.

• Mild – asymptomatic• With progression – dyspnea, orthopneas, dry

cough, hemoptysis, and pulmonary edema may appear

• Right sided heart failure symptoms occur later • Signs

– Atrial fibrillation – Apical diastolic murmur is heard

Page 13: Valvular Heart DISEASE. What is Valvular Heart Disease?

aortic stenosis

• characterized by an abnormal narrowing of the aortic valve opening.

Page 14: Valvular Heart DISEASE. What is Valvular Heart Disease?

Causes of Aortic Valve Stenosis

1)Most commonly, aortic stenosis is due to age-related progressive calcification

3)Rheumatic aortic stenosis(10%)

Page 15: Valvular Heart DISEASE. What is Valvular Heart Disease?
Page 16: Valvular Heart DISEASE. What is Valvular Heart Disease?

Clinical presentation

• Congestive heart failure

• Syncope• Angina

Page 17: Valvular Heart DISEASE. What is Valvular Heart Disease?

Aortic Regurgitation

• is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle.

• Causes:• Infective endocarditic• Rheumatic disease• Trauma• Aortic dilatation like in Marfan’s

Syndrome, syphilis

Page 18: Valvular Heart DISEASE. What is Valvular Heart Disease?

Mitral Stenosis

• Usually results from rheumatic carditis• Is a thickening by fibrosis or calcification• Can be caused by tumors, calcium and thrombus • Valve leaflets fuse• These narrows the opening and prevents normal blood

flow from the LA to the LV• LA pressure increases, left atrium dilates, PAP

increases, and the RV hypertrophies• Pulmonary congestion and right sided heart failure

occurs• Followed by decreased preload and CO decreases

Page 19: Valvular Heart DISEASE. What is Valvular Heart Disease?
Page 20: Valvular Heart DISEASE. What is Valvular Heart Disease?

Mitral Stenosis, cont.

• Mild – asymptomatic• With progression – dyspnea, orthopneas, dry

cough, hemoptysis, and pulmonary edema may appear

• Right sided heart failure symptoms occur later • Signs

– Atrial fibrillation – Apical diastolic murmur is heard

Page 21: Valvular Heart DISEASE. What is Valvular Heart Disease?

Mitral regurgitation : -occurs when the mitral valve does

not close properly while the heart pumps out blood .

-Most common cause is mitral valve prolapse (MVP) .

-Pathophysiology ; blood leaks back into LA> dilatation of LA >reduction in LV systolic function>later LV dilatation.

-symptoms are (palpitation- dyspnea- edema- fatigue- ascitis)

Page 22: Valvular Heart DISEASE. What is Valvular Heart Disease?

diagnostic tests

• Echocardiography .• Transesophageal

echocardiography . • Cardiac catheterization .

(also called an angiogram)

• MRI

Page 23: Valvular Heart DISEASE. What is Valvular Heart Disease?
Page 24: Valvular Heart DISEASE. What is Valvular Heart Disease?
Page 25: Valvular Heart DISEASE. What is Valvular Heart Disease?

Treatment of valvular heart disease

• Drugs to facilitate myocardial functioning

• Surgical-valve replacement/valve repair

Page 26: Valvular Heart DISEASE. What is Valvular Heart Disease?

Medial Treatment

• Nonsurgical management focuses on drug therapy and rest

• Diuretic, beta blockers, digoxin, O2, vasodilators, prophylactic antibiotic therapy

• Manage atrial fibrillation , if develops, with conversion if possible, and use of anticoagulation

Page 27: Valvular Heart DISEASE. What is Valvular Heart Disease?

Surgical Management of Valve Disease

• Mitral Valve– Mitral Valve Replacement– Balloon Valvuloplasty

• Aortic Valve Replacement

Page 28: Valvular Heart DISEASE. What is Valvular Heart Disease?

Baloon valvuloplasty

Page 29: Valvular Heart DISEASE. What is Valvular Heart Disease?

Mechanical Valve

Page 30: Valvular Heart DISEASE. What is Valvular Heart Disease?

Mechanical Valve

Page 31: Valvular Heart DISEASE. What is Valvular Heart Disease?

Tissue Valve

Page 32: Valvular Heart DISEASE. What is Valvular Heart Disease?

Advantages of surgical repair

• Reducing progression into heart faliure

• better functional outcome

Disadvantages

• Valve failure

• Some valves warrant life long anticoagulatioln

Page 33: Valvular Heart DISEASE. What is Valvular Heart Disease?

Thank you….