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Valvular Heart Disease I

Valvular Heart Disease I . Howard Sacher, D.O. Long Island Cardiology and Internal Medicine. Calcified Ao Valve 2 nd to acquired AoV Stenosis. Severely calcified tricuspid valve from an elderly patient.

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Valvular Heart Disease I

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  1. Valvular Heart Disease I Howard Sacher, D.O. Long Island Cardiology and Internal Medicine

  2. Calcified Ao Valve 2nd to acquired AoV Stenosis

  3. Severely calcified tricuspid valve from an elderly patient

  4. Phonogram of a 20yoa women with moderate AoV congenital stenosis with a bicuspid valve, presenting with an ejection click, increased A2 and systolic ejection murmur

  5. Phonogram of a 20yoa male with severe non-calcified AoVS. Seen here is a paradoxical splitting of S2, late systolic ejection murmur and prominent S4. The LV is noted to have a low volume and a slow up swing of the carotid pulse.

  6. Apexcardiogram of the severe AoVS showing a sustained “a” wave, causing a palpable S4 gallop (the non-compliant ventricle)

  7. 70yoa male with sever AoVS, note the absence of both the ejection click and Ao second sound (circled). Also there is a slow up swing of the carotid pulse.

  8. The window to the inner world – The Eyes • Note the multiple calcific emboli in the retina of this elderly patient presenting with amaurosis fugax • Patient was Dx with severe acquired AoVS

  9. Catheter gradients are reported as peak to peak pressure differences • This is not a true measurement of pressure drop off across the AoV because they do not occur at the same time • Echocardiogram is ideal for pressure drop off across the valve • The two should be used together to evaluate the patient for validation studies • Peak to Peak pressure diff • Pressure Drop off

  10. Percutanous valvuloplasty with a prophylactic RV Pacemaker to combat bradycardia during the procedure

  11. Ross Procedure

  12. Survival in the elderly (ave age of 60) after a AoV replacement (AVR)

  13. Pt with Marfan’s syndrome

  14. Marfan’s with type-A Ao dissection

  15. Growth the heart muscle A – Infant’s heart weighing about 15gm and LV is 7gm B – Adult’s weighing 300gm and 100gm respectively C – Athlete's is 500gms and 200gm D – Concentric Hypertrophy – 650gms and 400gms E – Decompensated Eccentric Hypertrophy – 900gms and 500gms – fewer myocytes are noted, replaced by fibrotic scar tissue

  16. rh

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