BCS 6.1

The PRESSURE GRADIENT is the difference in pressure between the upstream chamber (higher pressure) and the downstream chamber (lower pressure) during the time of flow when the valve is normally open.

An Aschoff Body is a characteristic lesion found in the heart tissue of patients with acute rheumatic carditis, representing areas of necrosis surrounded by inflammatory cells.

Antistreptolysin masses are composed of fibrin, platelets, and infecting organisms, held together by agglutinating antibodies produced by the bacteria.

Commonly tricuspid semi-lunar valves that can be congenitally bicuspid.

Rheumatic Fever is an acute immunologically mediated, multi-system inflammatory disease that occurs a few weeks after an episode of Group A (ß-hemolytic) streptococcal pharyngitis.

A condition characterized by thickening and distortion of the aortic valve cusps, often accompanied by commissural fusion, leading to aortic stenosis.

Verrucae are small warty vegetations, averaging only a few millimeters, seen along the closure line of valves and associated with acute rheumatic fever.

An Aschoff Body is a pathological finding in acute rheumatic carditis characterized by central necrosis surrounded by a mononuclear inflammatory infiltrate, including activated macrophages with prominent nuclei and central caterpillar chromatin.

A condition characterized by the redundancy and ballooning of the mitral valve leaflets, often leading to elongated and thin chordae tendineae.

Bi-cuspid flaps supported by chordae tendineae attached to papillary muscles.

Infective endocarditis is an infection of the inner lining of the heart chambers and valves, often caused by bacteria, which can lead to severe complications if untreated.

Devices implanted in the heart to replace damaged or diseased valves, helping to regulate blood flow.

Mitral Annular Calcification is the deposition of calcium in the fibrous ring (annulus) of the mitral valve, which can lead to functional impairment of the valve and is often associated with aging and various cardiovascular conditions.

The most frequent of all valvular abnormalities, characterized by heaped up calcified masses, typically onset occurs in the elderly, particularly in their 70s and 80s if they had previously normal valves, or in their 50s and 60s in individuals with congenital bicuspid valves.

Splinter hemorrhages are subungual, linear, dark red streaks that can occur in patients with infective endocarditis.

The Normal Aortic Valve Inlet is the area where the aortic valve is located, characterized by three valvular cusps and three distinct commissures.

Heaped up calcified masses on the outflow side of cusps that protrude into the sinuses of Valsalva, impeding valve opening.

The 'fish mouth' deformity is a typical manifestation of chronic rheumatic scarring of the mitral valve, characterized by fibrous thickening and distortion of the valve leaflet.

Bacterial Endocarditis is an infection that tends to spread from the valve surface onto adjacent endocardium and myocardium, characterized by friable vegetations that are liable to embolization.

Auricular thrombosis refers to the formation of a blood clot in the atrium of the heart, often associated with conditions like atrial fibrillation.

The splinter hemorrhages seen on the left thumb are associated with infective endocarditis and a positive blood culture for Staphylococcus aureus.

The three distinct commissures are the points where the three valvular cusps meet at the aortic valve inlet.

The main changes include fibrous thickening and distortion of the valve leaflet, commissural fusion, and thickening and shortening of chordae tendineae.

A condition where the aortic valve has only two cusps instead of three, which can lead to calcification and stenosis.

Friable vegetations are unstable growths on heart valves that can easily break off and lead to embolization.

Pulmonary venous congestion refers to the accumulation of blood in the pulmonary veins, leading to increased pressure and potential respiratory complications.

Valvular Stenosis is the failure of valvular opening leading to impaired forward flow, often caused by primary cusp abnormalities and can be a chronic process involving calcification or valve scarring.

Atrial fibrillation is an irregular and often rapid heart rate that can lead to blood clots, stroke, and other heart-related complications.

A type of cardiac valve prosthesis that does not require anticoagulation, is less durable, and may stiffen over time, leading to eventual stenosis and calcification.

Degenerative calcific deposits in the ring of the mitral valve that generally do not affect valvular function but can lead to mitral regurgitation, and are a source of thrombi and emboli, also prone to infective endocarditis.

The mitral valve is most often affected in rheumatic heart disease.

Conditions affecting the heart valves, including rheumatic heart disease (RHD), mitral valve prolapse, bicuspid aortic valves, calcific aortic stenosis, and prosthetic valves.

Potential complications include septic infarct and mycotic aneurysm.

A Cardiac Valve Prosthesis is a medical device implanted in the heart to replace a damaged or diseased heart valve, allowing for proper blood flow through the heart.

Colonisation or invasion of heart valves or mural endocardium by a microbiologic agent.

Incompetence (Regurgitation) refers to the failure of valvular closure, resulting in backflow of blood due to primary cusp abnormalities or disruption of supporting structures such as the aorta, mitral annulus, tendinous cords, papillary muscle, and ventricular wall.

Dilation of the pulmonary trunk and right atrium indicates increased pressure or volume overload, often associated with heart conditions such as valvular disease.

The Tricuspid Valve is a heart valve located between the right atrium and right ventricle, consisting of three flaps (cusps) that prevent backflow of blood.

Auricular thrombosis in atrial fibrillation is often secondary to conditions such as mitral stenosis, which disrupts normal blood flow and increases the risk of clot formation.

Mechanical valves require anticoagulation, which carries the risk of hemorrhage or thrombosis, and can cause red cell hemolysis due to the 'waring blender effect'.

Most common in women over 60.

Factors such as neutropenia, immunodeficiency, malignancy, diabetes mellitus, and alcohol or intravenous drug abuse.

The most common sites involve the left heart valves.

Formation of bulky, friable vegetations composed of thrombotic debris and organisms.

A Chest X-ray showing a prosthetic valve indicates the presence of an artificial heart valve, which can help assess the position and function of the valve post-surgery.

Displacement of the barium esophagram by an enlarged left atrium suggests the presence of left atrial enlargement, which can be a consequence of mitral valve disease.

Mixed valvular disease can arise from a combination of stenosis and incompetence, reflecting both impaired forward flow and backflow of blood.

Semi-lunar valves are a type of heart valve located at the exit of the ventricles, specifically the aortic and pulmonary valves, that prevent backflow into the heart.

A condition characterized by myxomatous degeneration of the mitral valve, leading to ballooning of the valvular cusps, more commonly affecting females.

Mitral stenosis is a narrowing of the mitral valve opening, which can impede blood flow from the left atrium to the left ventricle.

Complications may include stiffening leading to stenosis, calcification causing stenosis, and potential perforation or tearing resulting in insufficiency.

A condition characterized by the retrograde flow of blood 'upstream' during the time when a valve is normally closed, leading to volume overload.

The tricuspid valves are typically involved in intravenous drug abusers.

Leads to destruction of underlying cardiac tissue.

Staph aureus is a common organism responsible for acute endocarditis, affecting 10-20% of cases, and can occur on both normal and diseased valves, particularly in IV drug abusers.

A pathological change in the valve structure, often associated with Mitral Valve Prolapse, characterized by the degeneration of connective tissue.

Chordae tendineae are fibrous cords that connect the papillary muscles to the flaps of the heart valves, helping to stabilize the valves during the cardiac cycle.

A hemodynamic abnormality resulting from the excessive volume of blood returning to the heart due to regurgitation.

Bulky, friable vegetations composed of necrotic debris, thrombus, and organisms, which may be single or multiple.

The development of infective endocarditis is preventable by provision of antibiotic cover for any surgical or dental procedures.

Source of infective embolisation and septic infarcts.

A type of endocarditis characterized by the presence of vegetations, which are abnormal growths of tissue on the heart valves or endocardium.

Strep viridans and HACEK organisms (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella) are associated with subacute endocarditis, particularly in patients with previously damaged valves.

The mid systolic click is a characteristic auscultatory finding associated with Mitral Valve Prolapse, indicating the abnormal motion of the valve cusps.

The most important consequence of rheumatic fever characterized by inflammatory deformity of the heart valves, primarily affecting the mitral valve but can also involve the aortic or other valves.

The backward flow of blood that occurs when a valve fails to close properly, causing blood to flow in the opposite direction.

Leaflet thickening refers to the abnormal thickening of the heart valve leaflets that occurs during the chronic phase of Rheumatic Valvular Disease.

They may erode into the underlying myocardium to produce a ring abscess.

Foci of fibrinoid degeneration surrounded by lymphocytes, indicative of rheumatic heart disease.

A condition resulting from rheumatic fever, which can cause permanent damage to the heart valves due to inflammation.

Culture negative endocarditis refers to cases where no organisms are identified in blood cultures, often due to prior antibiotic treatment.

Marfan’s syndrome, which involves a mutation in the gene encoding fibrillin, is associated with an increased risk of Mitral Valve Prolapse due to connective tissue abnormalities.

The mitral valve is almost always involved in Chronic Rheumatic Valvular Heart Disease.

Clinical features of aortic stenosis include backward effects such as high left ventricular pressure, left ventricular hypertrophy, and pulmonary edema, as well as forward effects like angina or congestive heart failure (CHF) and syncope due to low perfusion.

A large, irregular, reddish tan vegetation.

Commissure fusion is the abnormal joining of the edges of the heart valve leaflets, leading to restricted movement and function of the valve.

An inflammation affecting all layers of the heart, including pericarditis, myocarditis, and endocarditis.

An infection of the inner lining of the heart chambers and valves, typically caused by bacteria or other infectious agents.

A condition characterized by the narrowing of the mitral valve opening, leading to obstruction of blood flow from the left atrium to the left ventricle.

Females are more commonly affected by Mitral Valve Prolapse compared to males.

Yes, involvement of the aortic valve or other valves is also common in Chronic Rheumatic Valvular Heart Disease.

Left ventricular hypertrophy due to aortic stenosis occurs as a compensatory response to increased pressure overload, ultimately leading to decreased cardiac output.

In chronic Rheumatic Valvular Disease, the chordae tendineae undergo shortening, thickening, and fusion, which can impair valve function.

Virulent organisms such as Staphylococcus aureus.

Also called Marantic endocarditis, it is a non-infective condition that tends to occur in persons with a hypercoagulable state, often associated with malignancies.

Plump macrophages with abundant cytoplasm and central nuclei with wavy chromatin, also known as caterpillar cells.

A type of endocarditis associated with cancer or chronic illness, characterized by sterile vegetations on the heart valves.

The left atrium becomes enlarged, displacing the left atrial appendage outward.

Backward effects of aortic stenosis include high left ventricular pressure, left ventricular hypertrophy, and pulmonary edema.

The fish moth or button hole deformity is a structural abnormality caused by fibrous bridging across the commissures of the heart valves.

Organisms such as the Streptococcus viridans group.

Fibrinoid necrosis and fibrin deposition form vegetations, known as Verrucae, causing minimal disturbance in valve function.

A paraneoplastic syndrome associated with malignancies, which leads to a hypercoagulable state, often linked to Non bacterial thrombotic endocarditis.

A form of endocarditis associated with systemic lupus erythematosus, characterized by sterile vegetations on the heart valves.

It refers to the overlapping of the left atrium and right atrium, creating a visual appearance of increased density on imaging.

Forward effects of aortic stenosis include angina or congestive heart failure (CHF) and syncope due to low perfusion.

Vascularization of the valve leaflet indicates the development of new blood vessels within the heart valve leaflets, which is a pathological change in Rheumatic Valvular Disease.

They are rarely over 0.5 cm in size, friable, and very prone to embolize.

The enlarged left atrium pushes the left main bronchus upwards, causing elevation.

A condition seen in 4% of SLE patients characterized by flat, pale tan, spreading vegetations over the mitral valve surface and chordae tendineae, which rarely cause problems or embolize.

A type of infective endocarditis characterized by a destructive infection caused by a virulent organism affecting a previously normal valve, leading to high morbidity and mortality.

4% of SLE patients are affected by Libman-Sacks endocarditis.

A type of infective endocarditis that is insidious in onset, caused by low virulence organisms, typically affecting previously scarred or damaged valves, and associated with low morbidity.

The vegetations are flat, pale tan, and spreading over the mitral valve surface and chordae tendineae.

A severe form of infection that leads to significant damage to heart valves and surrounding structures, often seen in acute cases.

No, they rarely cause problems because they are not large.

Microorganisms that cause infections with a lower intensity, often associated with subacute infective endocarditis and less severe clinical outcomes.

No, it rarely embolizes.

Refers to the significant rates of disease complications and death associated with acute infective endocarditis due to its aggressive nature.

Calcific aortic stenosis is a degenerative condition characterized by the calcification of the aortic valve, leading to narrowing and obstruction of blood flow from the heart.

A clinical presentation that develops slowly over time, making it less obvious and often leading to delayed diagnosis.

Mitral annular calcification is the deposition of calcium in the annulus of the mitral valve, which can contribute to mitral valve dysfunction.

Myxomatous degeneration of mitral valves, also known as mitral valve prolapse, is a condition where the mitral valve leaflets become thickened and may bulge into the left atrium during systole.

Rheumatic fever is an inflammatory disease that can develop after a streptococcal throat infection, potentially leading to rheumatic heart disease and damage to heart valves.

Infective endocarditis is an infection of the inner lining of the heart chambers and valves, usually caused by bacteria, leading to inflammation and potential damage to the heart valves.

Non-bacterial thrombotic endocarditis is a condition characterized by the presence of sterile vegetations on heart valves, often associated with underlying malignancies or chronic illnesses.

Mitral Stenosis leads to increased atrial volume and pressure.

Atrial dilatation is the enlargement of the atrium, which occurs as a result of increased pressure due to Mitral Stenosis.

Atrial thrombus can form as a complication of atrial dilatation in Mitral Stenosis.

Mitral Stenosis can lead to congestion of the lungs due to increased pressure in the pulmonary circulation.

Mitral Stenosis can cause pulmonary hypertension due to increased pressure in the pulmonary circulation.

Right heart failure can occur as a consequence of increased pressures and volume overload caused by Mitral Stenosis.

Systemic embolization refers to the obstruction of blood vessels by clots that can form in the dilated left atrium due to Mitral Stenosis.

Molt stasis refers to the stagnation of blood flow, which can occur due to the obstruction from Mitral Stenosis.

Mitral Stenosis can lead to impaired systemic circulation due to reduced cardiac output and increased pressures.