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Heart valve Wiki2Web Clarity Challenge

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Study Guide: Human Heart Valves: Structure, Function, and Pathology

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Human Heart Valves: Structure, Function, and Pathology Study Guide

Introduction to Cardiac Valves

The primary function of a cardiac valve is to ensure unidirectional blood flow through the heart's chambers, preventing retrograde movement.

Answer: True

Explanation: Cardiac valves are designed to ensure unidirectional blood flow through the heart's chambers, preventing retrograde movement.

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Mammalian hearts typically contain four valves, not three, to regulate blood flow.

Answer: True

Explanation: Mammalian hearts typically possess four cardiac valves: the mitral, tricuspid, aortic, and pulmonary valves.

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What is the fundamental role of any cardiac valve?

Answer: To ensure blood flows in a single direction, preventing backflow.

Explanation: The fundamental role of cardiac valves is to ensure unidirectional blood flow through the heart by opening to permit passage and closing to prevent retrograde movement.

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How many cardiac valves are typically present in a mammalian heart?

Answer: Four

Explanation: A mammalian heart is characterized by the presence of four principal cardiac valves: the mitral, tricuspid, aortic, and pulmonary valves.

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Which pair correctly categorizes the two principal classifications of cardiac valves?

Answer: Atrioventricular and Semilunar valves

Explanation: Cardiac valves are broadly classified into two functional groups: the atrioventricular valves (mitral and tricuspid) and the semilunar valves (aortic and pulmonary).

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Anatomy and Structure of Heart Valves

The atrioventricular valves are situated between the atria and ventricles, not at the entrance of the arteries leaving the heart.

Answer: True

Explanation: The atrioventricular valves (mitral and tricuspid) are located between the atria and ventricles. The semilunar valves (aortic and pulmonary) are located at the entrance of the arteries leaving the ventricles.

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The mitral valve, also known as the bicuspid valve, separates the left atrium from the left ventricle.

Answer: True

Explanation: The mitral valve, anatomically designated as the bicuspid valve due to its two leaflets, is precisely situated between the left atrium and the left ventricle.

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The aortic valve controls blood flow from the left ventricle into the aorta, not from the right ventricle into the pulmonary artery.

Answer: True

Explanation: The aortic valve regulates blood flow from the left ventricle into the aorta. The pulmonary valve controls flow from the right ventricle into the pulmonary artery.

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Heart valve leaflets, or cusps, are primarily composed of connective tissue and are passively moved by pressure gradients, not muscle tissue that actively pumps blood.

Answer: True

Explanation: Cardiac valve leaflets are primarily composed of dense connective tissue lined by endocardium. Their movement is passive, driven by pressure differentials, not active muscular contraction.

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The mitral valve is unique among the four main heart valves because it possesses two cusps.

Answer: True

Explanation: The mitral valve is distinct among the four principal cardiac valves as it comprises only two leaflets, hence its designation as the bicuspid valve.

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The posterior cusp is a defining feature of the mitral valve's structure.

Answer: True

Explanation: The mitral valve possesses anterior and posterior cusps. The presence and orientation of these cusps are defining structural characteristics.

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Chordae tendineae and papillary muscles are structures that anchor the atrioventricular valves to the ventricle walls, not the semilunar valves.

Answer: True

Explanation: The chordae tendineae and papillary muscles are integral components of the subvalvular apparatus that anchor the atrioventricular valves, preventing their inversion into the atria during ventricular systole. Semilunar valves lack these structures.

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The subvalvular apparatus, comprising chordae tendineae and papillary muscles, prevents atrioventricular valves from inverting during ventricular contraction.

Answer: True

Explanation: The subvalvular apparatus, consisting of chordae tendineae and papillary muscles, serves to prevent the prolapse or inversion of the atrioventricular valves into the atria during ventricular contraction. Semilunar valves do not possess this apparatus.

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The tricuspid valve is located on the right side of the heart, between the right atrium and right ventricle.

Answer: True

Explanation: The tricuspid valve is situated on the right side of the heart, separating the right atrium from the right ventricle. The mitral valve is located on the left side.

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The pulmonary valve is situated at the base of the pulmonary artery, controlling blood flow from the right ventricle.

Answer: True

Explanation: The pulmonary valve is located at the origin of the pulmonary artery, regulating blood flow from the right ventricle. The aortic valve is situated at the origin of the aorta, controlling flow from the left ventricle.

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Semilunar valves, unlike atrioventricular valves, do not possess chordae tendineae for structural support.

Answer: True

Explanation: Semilunar valves (aortic and pulmonary) lack the chordae tendineae and papillary muscles found in atrioventricular valves. Their structure is simpler, resembling pocket-like cusps.

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The atrioventricular valves are anchored to the ventricle walls by chordae tendineae; semilunar valves are not.

Answer: True

Explanation: The chordae tendineae anchor the atrioventricular valves to the papillary muscles within the ventricles. Semilunar valves do not possess these anchoring structures.

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The aortic valve has three cusps: left, right, and posterior.

Answer: True

Explanation: The aortic valve is typically composed of three cusps: the left coronary cusp, the right coronary cusp, and the posterior (non-coronary) cusp.

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Nodules on the tips of valve cusps serve to ensure a tighter seal when the valve closes, preventing leakage, not increasing turbulence.

Answer: True

Explanation: Nodules on the free edges of valve cusps, such as the nodule of Arantius on the aortic valve, contribute to the effective sealing of the valve leaflets when closed, thereby preventing regurgitation.

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The mitral valve is also referred to as the bicuspid valve; it is distinct from the tricuspid valve.

Answer: True

Explanation: The mitral valve is also referred to as the bicuspid valve due to its two leaflets, distinguishing it from the tricuspid valve, which has three.

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Semilunar valves are located at the exit of the ventricles into the great arteries; the atrioventricular valves are located between the atria and ventricles.

Answer: True

Explanation: Semilunar valves are positioned at the outflow tracts of the ventricles, connecting to the aorta and pulmonary artery. Atrioventricular valves are situated between the atria and ventricles.

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The tricuspid valve typically has three cusps; the mitral valve has two.

Answer: True

Explanation: The tricuspid valve is characterized by three leaflets or cusps, whereas the mitral valve is bicuspid, possessing only two.

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The subvalvular apparatus prevents the atrioventricular valves from prolapsing.

Answer: True

Explanation: The subvalvular apparatus, comprising chordae tendineae and papillary muscles, is specifically designed to prevent the prolapse of the atrioventricular valves into the atria during ventricular contraction. Semilunar valves do not have this apparatus.

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Where are the atrioventricular valves anatomically situated within the heart?

Answer: Between the upper atria and the lower ventricles.

Explanation: The atrioventricular valves are anatomically positioned between the cardiac atria and ventricles, controlling the flow of blood between these chambers.

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Which valve is situated at the origin of the aorta, regulating blood flow from the left ventricle?

Answer: Aortic valve

Explanation: The aortic valve is strategically located at the junction of the left ventricle and the aorta, ensuring unidirectional expulsion of oxygenated blood into the systemic circulation.

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Which cardiac valve is distinguished by possessing only two cusps (leaflets)?

Answer: Mitral valve

Explanation: The mitral valve is uniquely characterized by its bicuspid structure, consisting of two leaflets, in contrast to the tricuspid, aortic, and pulmonary valves, which typically have three.

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What is the collective term for the chordae tendineae and papillary muscles?

Answer: The subvalvular apparatus.

Explanation: The chordae tendineae and papillary muscles together constitute the subvalvular apparatus, a critical component for the proper function of the atrioventricular valves.

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Which valve is located on the right side of the heart, between the right atrium and right ventricle?

Answer: Tricuspid valve

Explanation: The tricuspid valve is anatomically situated on the right side of the heart, functioning as the interface between the right atrium and the right ventricle.

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What structural components, present in atrioventricular valves, are notably absent in semilunar valves?

Answer: Chordae tendineae and papillary muscles

Explanation: Semilunar valves are distinguished from atrioventricular valves by their lack of chordae tendineae and papillary muscles, relying solely on their leaflet structure and pressure gradients for function.

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Cardiac Valve Physiology and Auscultation

Atrioventricular valves prevent the backflow of blood from the ventricles into the atria during ventricular contraction (systole), not when the ventricles relax.

Answer: True

Explanation: Atrioventricular valves prevent retrograde blood flow from the ventricles into the atria during ventricular systole. Their closure is essential for forward propulsion of blood into the arterial system.

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Semilunar valves ensure that blood pumped out of the ventricles into the arteries remains there after contraction, preventing backflow into the ventricles.

Answer: True

Explanation: Semilunar valves (aortic and pulmonary) prevent the retrograde flow of blood from the aorta and pulmonary artery back into the ventricles after ventricular contraction.

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Heart valves open and close passively, driven by pressure differentials within the cardiac chambers and great vessels, not by direct electrical signals.

Answer: True

Explanation: Cardiac valves function passively, opening and closing in response to pressure gradients between the cardiac chambers and great vessels. They are not directly controlled by electrical signals.

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The 'lub' sound of the heart (S1) is primarily caused by the closure of the atrioventricular valves.

Answer: True

Explanation: The first heart sound ('lub' or S1) is generated by the closure of the atrioventricular valves (mitral and tricuspid) at the onset of ventricular systole.

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The P2 component of the second heart sound is produced by the closure of the pulmonary valve.

Answer: True

Explanation: The P2 component of the second heart sound (S2) is attributed to the closure of the pulmonary valve. The A2 component is due to the closure of the aortic valve.

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The 'dub' sound of the heart (S2) is caused by the closure of the semilunar valves.

Answer: True

Explanation: The second heart sound ('dub' or S2) is produced by the closure of the semilunar valves (aortic and pulmonary) at the termination of ventricular systole.

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The P2 component of the second heart sound is typically softer than the A2 component because the pressure in the pulmonary artery is lower than in the aorta.

Answer: True

Explanation: The A2 component (aortic valve closure) is generally louder than the P2 component (pulmonary valve closure) due to the higher systemic arterial pressure compared to the lower pulmonary arterial pressure.

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The Wiggers diagram helps illustrate the pressure changes and valve movements during the cardiac cycle.

Answer: True

Explanation: The Wiggers diagram is a graphical representation that synchronizes ventricular pressure, aortic pressure, atrial pressure, ventricular volume, and the timing of valve opening and closure, thereby illustrating the dynamics of the cardiac cycle.

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The closure of the aortic and pulmonary valves causes the second heart sound (S2).

Answer: True

Explanation: The closure of the aortic and pulmonary valves generates the second heart sound (S2). The first heart sound (S1) is produced by the closure of the mitral and tricuspid valves.

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Heart valves open and close passively based on pressure differences.

Answer: True

Explanation: The opening and closing of cardiac valves are passive events, governed by the pressure gradients that develop across them during the cardiac cycle.

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What is the primary physiological function of the semilunar valves?

Answer: To prevent backflow from the major arteries back into the ventricles after contraction.

Explanation: The principal function of the semilunar valves is to prevent the retrograde flow of blood from the aorta and pulmonary artery into the ventricles subsequent to ventricular contraction.

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By what mechanism do cardiac valves primarily open and close?

Answer: By responding passively to differences in blood pressure.

Explanation: Cardiac valves operate passively, opening and closing in response to the pressure gradients established between the cardiac chambers and great vessels during the cardiac cycle.

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The first heart sound ('lub' or S1) is associated with the closure of which set of cardiac valves?

Answer: Mitral and Tricuspid valves

Explanation: The first heart sound (S1), colloquially known as 'lub,' is primarily caused by the closure of the mitral and tricuspid valves, marking the beginning of ventricular systole.

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The A2 component of the second heart sound signifies the closure of which valve?

Answer: Aortic valve

Explanation: The A2 component of the second heart sound (S2) specifically denotes the closure of the aortic valve, which occurs at the onset of ventricular diastole.

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The second heart sound ('dub' or S2) is caused by the closure of which set of cardiac valves?

Answer: Semilunar valves

Explanation: The second heart sound (S2), or 'dub,' is produced by the closure of the semilunar valves (aortic and pulmonary) at the termination of ventricular systole.

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In the context of cardiac valve function, what physiological relationship does the equation a(∂Q/∂t) + bQ² = Δp describe?

Answer: The relationship between pressure drop and flow rate across an open valve.

Explanation: This equation models the relationship between the pressure gradient (Δp) across an open valve and the flow rate (Q), incorporating inertial effects (∂Q/∂t) and viscous resistance (Q²).

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Embryological Development and Historical Context of Cardiac Valves

Leonardo da Vinci used wax casts and glass models to study the structure of heart valves.

Answer: True

Explanation: Leonardo da Vinci conducted pioneering anatomical studies of cardiac valves, employing techniques such as dissections and the creation of wax casts to construct detailed models.

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The development of heart valves during embryogenesis involves endocardial cushions in the outflow tract for semilunar valves.

Answer: True

Explanation: The formation of semilunar valves during embryogenesis originates from endocardial cushions located within the outflow tract of the developing heart, which subsequently differentiate into valve leaflets.

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The Star-Edwards valve was the first artificial heart valve to be medically proven and adopted.

Answer: True

Explanation: The Starr-Edwards valve, developed by Dr. Albert Starr and engineer M. Lowell Edwards, was the first clinically successful and widely adopted prosthetic heart valve, implanted in 1960.

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Which of the following techniques did Leonardo da Vinci employ in his seminal studies of cardiac valve structure?

Answer: Performing dissections and creating wax models.

Explanation: Leonardo da Vinci's groundbreaking investigations into cardiac valve anatomy utilized meticulous dissection and the creation of detailed wax models to understand their form and function.

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The reference 'Anatomy photo:20:21-0102' likely pertains to an anatomical illustration of which cardiac valve?

Answer: Pulmonic Valve

Explanation: The reference 'Anatomy photo:20:21-0102' is associated with an anatomical illustration of the Pulmonic Valve, as provided by SUNY Downstate Medical Center.

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Pathology of Cardiac Valves: Stenosis and Regurgitation

Valvular heart disease is a broad term encompassing any dysfunction of the heart valves, not solely infections.

Answer: True

Explanation: Valvular heart disease is an umbrella term for any condition impairing heart valve function, including stenosis, regurgitation, and infections like endocarditis.

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Valve stenosis is a condition where a valve becomes narrowed and stiff, restricting forward blood flow, not one that becomes too loose allowing backflow.

Answer: True

Explanation: Valve stenosis is characterized by a narrowed valve orifice that impedes forward blood flow. Valve regurgitation, conversely, involves incomplete closure leading to backflow.

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Valve regurgitation occurs when a valve fails to close properly, allowing backward blood flow, not when it narrows.

Answer: True

Explanation: Valve regurgitation signifies an incompetent valve that permits retrograde blood flow due to incomplete closure. Valve stenosis involves a narrowed opening that obstructs antegrade flow.

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Infective endocarditis, a cause of valve inflammation, is typically caused by bacterial infections, although other microorganisms can be involved.

Answer: True

Explanation: Infective endocarditis is most commonly caused by bacterial pathogens, which can adhere to damaged valve surfaces and initiate inflammation and vegetation formation.

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Nonbacterial thrombotic endocarditis does not typically involve an inflammatory response and is often found on previously undamaged valves.

Answer: True

Explanation: Nonbacterial thrombotic endocarditis is characterized by the formation of sterile thrombi on valve leaflets, typically without significant inflammation, and can occur on previously healthy valves.

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Valve regurgitation is characterized by a valve that fails to close properly, allowing backward blood flow; a narrowed valve opening obstructing flow is characteristic of stenosis.

Answer: True

Explanation: Valve regurgitation results from incomplete valve closure, leading to retrograde blood flow. Valve stenosis, conversely, is defined by a narrowed valve orifice that impedes forward flow.

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What is cardiac valve stenosis characterized by?

Answer: A valve that is too stiff to open fully, obstructing flow.

Explanation: Cardiac valve stenosis is pathologically defined by a narrowed valve orifice, typically due to thickening and stiffening of the leaflets, which impedes forward blood flow.

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Which valvular pathology involves a cardiac valve failing to close properly, leading to blood leakage?

Answer: Regurgitation

Explanation: Regurgitation, also known as insufficiency or incompetence, describes the pathological state where a cardiac valve fails to achieve complete closure, resulting in retrograde blood flow.

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What is the typical cause of infective endocarditis, which can inflame heart valves?

Answer: A bacterial infection, often attaching to damaged valves.

Explanation: Infective endocarditis is most frequently precipitated by bacterial invasion of the endocardium, particularly on pre-existing valve lesions, leading to inflammation and vegetation formation.

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Congenital and Acquired Valvular Abnormalities

Mitral valve prolapse involves the displacement of valve cusps into the left atrium during ventricular contraction.

Answer: True

Explanation: Mitral valve prolapse is defined as the displacement of one or both mitral valve leaflets into the left atrium during ventricular systole, often due to myxomatous degeneration of the valve tissue.

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The most common form of congenital heart valve anomaly is a bicuspid aortic valve, not a tricuspid valve with four cusps.

Answer: False

Explanation: The most prevalent congenital anomaly of the heart valves is the bicuspid aortic valve, characterized by the fusion of two of the three aortic valve cusps during embryonic development.

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Tricuspid atresia is a congenital condition characterized by the complete absence of the tricuspid valve, not a valve with four leaflets.

Answer: True

Explanation: Tricuspid atresia is a severe congenital defect defined by the complete absence of a functional tricuspid valve, necessitating alternative pathways for blood flow from the right atrium to the right ventricle.

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Mitral valve prolapse involves the displacement of valve cusps into which cardiac chamber?

Answer: Left atrium

Explanation: In mitral valve prolapse, the mitral valve leaflets displace superiorly into the left atrium during ventricular systole.

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What is the most frequently encountered congenital anomaly of the heart valves?

Answer: Bicuspid aortic valve

Explanation: The bicuspid aortic valve, characterized by the fusion of two of the three aortic valve cusps, represents the most common congenital anomaly affecting the heart valves.

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Ebstein's anomaly is a congenital cardiac malformation primarily affecting which valve?

Answer: Tricuspid valve

Explanation: Ebstein's anomaly is a congenital disorder characterized by the displacement of the septal and posterior leaflets of the tricuspid valve into the right ventricle, leading to atrialization of the ventricle.

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What is the defining characteristic of tricuspid atresia?

Answer: There is a complete absence of the tricuspid valve.

Explanation: Tricuspid atresia is a congenital condition where the tricuspid valve fails to develop, resulting in a complete absence of the valve and a critical obstruction to blood flow from the right atrium to the right ventricle.

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Diagnosis and Management of Valvular Heart Disease

Breathlessness is a common symptom associated with left-sided valvular pathologies, such as aortic stenosis or mitral regurgitation, due to impaired cardiac output and pulmonary congestion. Tricuspid valve disease typically manifests with right-sided heart failure symptoms.

Answer: True

Explanation: Dyspnea or breathlessness is a common symptom associated with left-sided valvular pathologies, such as aortic stenosis or mitral regurgitation, due to impaired cardiac output and resultant pulmonary congestion. Tricuspid valve disease typically manifests with right-sided heart failure symptoms.

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Jaundice and liver dysfunction are potential symptoms associated with tricuspid valve disease.

Answer: True

Explanation: Severe tricuspid valve disease, particularly regurgitation, can lead to elevated right atrial pressure and systemic venous congestion, manifesting as hepatomegaly, jaundice, and other signs of liver dysfunction.

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Fever and splinter hemorrhages are signs associated with valvular disease caused by infectious conditions like infective endocarditis, not typically non-infectious conditions like myxomatous degeneration.

Answer: True

Explanation: Fever, splinter hemorrhages, Osler nodes, and Janeway lesions are characteristic clinical findings of infective endocarditis, an infectious process affecting heart valves, rather than non-infectious conditions like myxomatous degeneration.

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Echocardiography is the primary diagnostic tool used to assess valvular heart disease.

Answer: True

Explanation: Echocardiography, utilizing ultrasound technology, is the cornerstone diagnostic modality for evaluating cardiac valve structure, function, and the presence and severity of valvular heart disease.

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Valvular heart disease cannot always be treated solely through medication; surgical intervention (repair or replacement) is often necessary.

Answer: True

Explanation: While medications can manage symptoms and complications of valvular heart disease, definitive treatment for significant valve dysfunction often requires surgical or interventional procedures such as valve repair or replacement.

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Breathlessness can be a symptom of valvular diseases affecting the aortic valve.

Answer: Aortic valve

Explanation: Dyspnea or breathlessness is a common symptom of left-sided valvular pathologies, such as aortic stenosis or mitral regurgitation, due to impaired cardiac output and resultant pulmonary congestion. Tricuspid valve disease typically manifests with right-sided heart failure symptoms.

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Which diagnostic tool is primarily utilized for the visualization and functional assessment of cardiac valves?

Answer: Echocardiography (Ultrasound)

Explanation: Echocardiography is the principal diagnostic modality for assessing cardiac valve morphology and dynamics, providing detailed real-time imaging.

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Which of the following represents a significant feared complication of valvular heart disease?

Answer: Formation of emboli (traveling blood clots)

Explanation: A major feared complication of valvular heart disease, particularly with turbulent flow or vegetations, is the formation and potential embolism of blood clots, leading to systemic or pulmonary thromboembolism.

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Which of the following is *not* a typical clinical sign associated with valvular heart disease of infectious etiology?

Answer: Thickened, narrowed valve leaflets (Stenosis)

Explanation: Fever, Osler nodes, and Janeway lesions are indicative of infectious endocarditis. Thickened, narrowed valve leaflets (stenosis) are a structural consequence of valvular disease, which can be infectious or non-infectious, but stenosis itself is not a direct sign of active infection.

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