Difference between revisions of "Heart valves"

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Heart valves (view source)

Revision as of 17:45, 16 April 2014

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→‎Calcific aortic stenosis
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==Calcific aortic stenosis==
==Calcific aortic stenosis==
*Abbreviated ''CAS''.
*Abbreviated ''CAS''.
===General===
{{Main|Calcific aortic stenosis}}
*Somewhat similar to [[atherosclerosis]]; however, considered a separate entity.<ref>{{cite journal |author=Otto CM |title=Calcific aortic stenosis--time to look more closely at the valve |journal=N. Engl. J. Med. |volume=359 |issue=13 |pages=1395-8 |year=2008 |month=September |pmid=18815402 |doi=10.1056/NEJMe0807001 |url=}}</ref>
*Mitral valve is usually normal.
*Most common cause of aortic stenosis.
 
DDx of aortic stenosis:
#Calcific aortic stenosis.
#[[Bicuspid aortic valve]] with calcific aortic stenosis.
#[[Rheumatic heart disease]].
 
Clinical (mnemonic ''SAD''):
*Syncope.
*Angina.
*Dyspnea (shortness of breath) - first symptom.
 
===Microscopic===
Features:<ref name=Ref_PBoD590>{{Ref PBoD|590}}</ref>
*[[Dystrophic calcification]]<ref name=pmid12779138>{{Cite journal  | last1 = Novaro | first1 = GM. | last2 = Griffin | first2 = BP. | title = Calcific aortic stenosis: another face of atherosclerosis? | journal = Cleve Clin J Med | volume = 70 | issue = 5 | pages = 471-7 | month = May | year = 2003 | doi =  | PMID = 12779138 | URL = http://www.ccjm.org/cgi/pmidlookup?view=long&pmid=12779138 }}</ref> - affects the valsalva side of the valve.
**It affects the fibrosa.
*Primarily at the base of the valve, i.e. there is relative sparing the free edge.
 
Note:
*There should be no [[neutrophil]]s and no microorganisms.
*An expanded spongiosa layer may be seen in the context of calcification.{{fact}}
 
DDx:
*[[Infective endocarditis]] - inflammatory cells (esp. neutrophils), microorganisms (e.g. cocci).
*[[Bicuspid aortic valve]].
*[[Rheumatic heart disease]].
 
===Sign out===
<pre>
AORTIC VALVE, VALVE REPLACEMENT:
- CALCIFIC AORTIC STENOSIS.
</pre>
 
====Micro====
The sections show valve tissue with marked calcification of the fibrosa layer. No neutrophils are identified. No microorganisms are identified with routine stains.


==Localized dystrophic heart valve amyloidosis==
==Localized dystrophic heart valve amyloidosis==
Michael
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