Mitral valve stenosis
Aetiology
· rheumatic fever
Pathophysiology
Valvular leaflets fuse decreasing orifice size
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Rise in left atrial pressure, left atrial hypertrophy and dilatation
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Domino effect of increasing pressure in the pulmonary circulation
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Pulmonary capillary pressure exceeds oncotic pressure of plasma proteins in blood (pulmonary oedema)
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Pulmonary hypertension
Right ventricular hypertrophy
Right ventricular dilatation
Right ventricular failure
Signs and symptoms
· asymptomatic for ten to twenty years
· fatique
· dyspnoes
· palpitations
· cough and haemoptysis
· embolic phenomena
· atrial dysrhythmias
Aortic valve stenosis
Aetiology
· congenital (manifests <>
· rheumatic (manifests 30-70 years of age)
· idiopathic (aging)
· degenerative (manifests > 70 years)
Clinically significant when reduced to a third of its size.
Pathophysiology
Increased left ventricular systolic pressure
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Left ventricular hypertrophy
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Left ventricular dilation
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Left ventricular failure
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Coronary insufficiency
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Increased left atrial pressure
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Pulmonary oedema and right ventricular failure
Signs and symptoms
· angina
· syncope
· heart failure
Aortic valve regurgitation
Aetiology
· rheumatic fever
· marfan’s syndrome
· syphilis
· rheumatoid arthritis
Pathophysiology
Diastolic regurgitation through aortic valve
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Left ventricular dilation
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Left ventricular hypertrophy
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Left ventricular failure
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Coronary insufficiency
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Pulmonary congestion
Pulmonary oedema
Dyspnoea
Right ventricular failure
Tricuspid valve regurgitation
Aetiology
· uncommon
· rheumatic fever
Pathophysiology
Elevated right atrial pressure
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Right atrial dilation
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Systemic venous congestion
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Jugular venous distension
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Hepatomegaly, Cirrhosis, Jaundice
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Ascites, Oedema
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