valvular heart dz

[MudPhud20XX]

Just out of curiosity, it seems like among the 4 heart valves, mitral and aortic seem to be most related to pathology.

1. So any particular reason why?

2. Firecracker says the most important risk factor for atrial fibrillation is mitral valve stenosis. How about tricuspid valve stenosis? Theoretically tricuspid valve stenosis will result in dilation of Rt. atrium and can cause atrial fibrillation, right?

I would really appreciate some insight.

Many thanks in advance.

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[thehundredthone]

Off the top of my head:

1. The pressures on the right side are really low, because the resistance to flow is minimal. This possibly results in less shear stress on the valves and hence less likelihood of damage. Usually right heart valve damage is secondary to left sided damage or congenital heart disease.

https://circ.ahajournals.org/content/119/20/2726.full

2. Yes it can, it's probably just not common enough to be considered an important risk factor.

 

[MudPhud20XX]

Off the top of my head:

1. The pressures on the right side are really low, because the resistance to flow is minimal. This possibly results in less shear stress on the valves and hence less likelihood of damage. Usually right heart valve damage is secondary to left sided damage or congenital heart disease.

https://circ.ahajournals.org/content/119/20/2726.full

2. Yes it can, it's probably just not common enough to be considered an important risk factor.

The pressure reason makes sense! thanks man.

 

[bulldogmed]

The pressure reason makes sense! thanks man.

Out of curiosity, MudPhud, where are you in your studies? What is your curriculum? You're asking a lot of questions on the step 1 forum. I'm assuming you haven't had pathology. Do you have a copy of Baby Robbins? That would probably be able to answer most of your path questions, and will probably be your primary text for that class next year.

 

[MudPhud20XX]

Out of curiosity, MudPhud, where are you in your studies? What is your curriculum? You're asking a lot of questions on the step 1 forum. I'm assuming you haven't had pathology. Do you have a copy of Baby Robbins? That would probably be able to answer most of your path questions, and will probably be your primary text for that class next year.

Thanks Bulldogmed, just sent you a message. Many thanks to your help.

 

[bulldogmed]

Thanks Bulldogmed, just sent you a message. Many thanks to your help.

No problem!

 

[Instatewaiter]

Just out of curiosity, it seems like among the 4 heart valves, mitral and aortic seem to be most related to pathology.

1. So any particular reason why?

2. Firecracker says the most important risk factor for atrial fibrillation is mitral valve stenosis. How about tricuspid valve stenosis? Theoretically tricuspid valve stenosis will result in dilation of Rt. atrium and can cause atrial fibrillation, right?

I would really appreciate some insight.

Many thanks in advance.

The LV is why both MV and AV are related to pathology. The RV is essentially a low pressure conduit to the lungs. The left side is a high pressure system and therefore the valves are more important to prevent back flow. Therefore a valve that is regurgitant is going to cause more problems on the left side than on the right side. Furthermore rheumatic heart disease, valve calcification and endocarditis affect the AV and MV more often.

Tricuspid stenosis almost never happens whereas mitral stenosis is relatively common 2/2 rheumatic heart disease. While not always, AF usually comes from the left atrium. As such, anything that dilates the left atrium (all the things that increase the atrial pressure: MR, MS, long standing AS, severe longstanding cardiomyopathy) will cause A-fib.