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TEST 3 - Advanced Pathophysiology Summer 2018 UTA 5315 Study Guide Solutions Mitral Valve Stenosis - ANSWER-- Characterized by NARROWING of mitral valve - Normal is 4-6 cm -Narrowed is less than 2.5 cm - Caused by RHEUMATIC FEVER -More common in WOMEN -Oxygenated blood comes back into heart...

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  • November 19, 2024
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TEST 3 - Advanced Pathophysiology
Summer 2018 UTA 5315 Study Guide
Solutions

Mitral Valve Stenosis - ANSWER✔✔-- Characterized by NARROWING of mitral valve


- Normal is 4-6 cm


-Narrowed is less than 2.5 cm


- Caused by RHEUMATIC FEVER


-More common in WOMEN


-Oxygenated blood comes back into heart into the left atrium and down through the

mitral valve to the left ventricle


- Complex: Stenosis leads to volume/pressure in left atrium, which results in atrial

hypertrophy/dilation, which increases pressure/volume in the pulmonary circulation

& causes PULMONARY EDEMA


- Simplified: Skinny mitral valve doesn't let blood pass through easily, so blood backs

up into the left atrium and causes it to swell, then backs up into the lung and causes

resp. symptoms


Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 1/61

,-S/sx: dyspnea, hemoptysis, a-fib, dysphagia, pulmonary hypertension


Mitral Valve Regurgitation - ANSWER✔✔--Characterized by INCOMPLETE CLOSURE

of mitral valve


-Caused by MITRAL VALVE PROLAPSE (flaps don't close together properly, leaving

valve ajar); more common in WOMEN; STICKING CHEST PAIN


-Blood in left ventricle backs up to left ventricle during systole (mitral valve should be

closed during systole/contraction of heart)


-Leads to atrial dilation/hypertrophy, increased pulmonary vascular pressure/volume,

PULMONARY EDEMA


-S/sx: Dyspnea, rales, pansystolic murmur, S3 & S4 heart sounds


Aortic Valve Stenosis - ANSWER✔✔--Most common valvular disease


-Most common causes are aortic valve CALCIFICATION (stiffening) in people over 60;

congenital aortic valve stenosis in people less than 30


-Normal valve 3 cm; symptoms seen when valve less than 1 cm; severe when valve is

less than 0.5 cm


-Narrowed valve prevents outflow from left ventricle to aorta. This backs up blood to

the left atrium and ultimately floods the lung causing PULMONARY EDEMA


S/Sx: Pulmonary hypertension/edema, poor outflow of aorta to body (aorta sends out

oxygenated blood to body), causing fainting or chest pain

Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 2/61

,Simplified: Aorta is stiff and can't send out oxygenated blood properly to the body,

depriving tissues of oxygen. Blood gets backed up into lungs, causing pulmonary

edema.


Aortic Valve Regurgitation - ANSWER✔✔--Valve is TOO WIDE or TOO NARROW,

blood doesn't pass through effectively, causing back flow of blood into the left ventricle




-Marked by EARLY DIASTOLIC MURMUR (on systole, heart contracts and pushes

blood up the aorta, but on diastole, heart relaxes and ineffective aortic valve is not able

to hold blood up in aorta, so blood falls and makes a swish sound, which is the

murmur)


-Most commonly caused by AORTIC ROOT DILATION(starting point of aorta is too

wide)


-Other causes: infective endocarditis, rheumatic fever, aortitis from syphilis, coarctation

(congenital narrowing of aorta), aortic dissection (tear), ankylosing spondylitis

(inflammatory arthritis)




-Acute: increases left ventricular end-diastolic pressure (LVEDP) (increased blood back

down in the left ventricle increases pressure), decreased stroke volume (not much blood

is being pushed from left ventricle because blood's backed up and overwhelming left



Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 3/61

, ventricle), normal or decreased pulse pressure, decreased cardiac output (aorta is not

effectively pumping blood from heart)




Chronic: Body adjusts; LVEDP normalizes, systolic bp increases (compensation: harder

contraction to push blood out of aorta before it falls back down to left ventricle),

diastolic bp decreases (compensation: decreased relaxation of heart to stop blood from

seeping back out of aorta), cardiac output is normal, pulse pressure is increase. Blood

ultimately is backed up into the left atrium and pulmonary circulation.


Atherosclerosis Causes - ANSWER✔✔--Begins with tissue injury


Sources of injury:


CIGARETTES (toxins)


Hypertension (increased force of the blood hitting the blood vessel can weaken it)


Diabetes


Hyperlipidemia (lipids take place of endothelial cells lining the blood vessel, initiating

an inflammatory response)


Patho of Atherosclerosis r/t Hyperlipidemia - Inflammatory Response - ANSWER✔✔-

1. Tissue injury to endothelial cells lining the blood vessel.




Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 4/61

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