Heart murmur, dyspnoea and swollen ankles

The aim of this topic is to review disorders of heart valves, including those produced by congenital, degenerative, rheumatic and infective diseases, as well as disorders of cardiac muscle. The pathophysiology of congestive cardiac failure as a consequence of these lesions should be emphasised.

Learning objectives:

At the completion of this topic you should be able to:

1. Describe the anatomy and histology of the heart valves.
2. Describe the aetiology of the main forms of valvular heart disease, and describe the epidemiological differences between them.
3. Outline the factors that predispose to the development of infective endocarditis, in terms of cardiac abnormalities and the source and nature of the infecting organism.
4. Describe the local and systemic complications that may result from infective endocarditis.
5. Outline the investigations that are important in the diagnosis of infective endocarditis.
6. Describe the pathogenesis of acute rheumatic fever and chronic rheumatic heart disease, and relate the clinical features to pathological changes in an affected valve.
7. Describe the pathological changes and consequences of the forms of congenital valvular heart disease, including mitral valve prolapse and bicuspid aortic valve.
8. Describe the process of senile degeneration of the aortic valve, and correlate that with its clinical manifestations.
9. Define and classify the cardiomyopathies. State the common causes of dilated cardiomyopathy.
10. Describe the pathophysiological sequence of events by which mitral stenosis may lead to congestive cardiac failure.
11. Outline the likely abnormalities at autopsy in a patient with long-standing congestive cardiac failure.

1. Explain the clinical manifestations of infective endocarditis with regard to the cardiac, embolic and immunological effects.
2. Write brief notes on the pathogenesis of chronic rheumatic heart disease.

Other relevant protocol - 42

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