Cardiac Valve Disease Tutorial

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Describe the anatomy of the heart, including: cardiac chambers and valves, and the great vessels entering and leaving the heart.
What are the seven phases of the cardiac cycle and how is each phase related temporally to the electrocardiogram?
What changes occur in ventricular and atrial pressures, ventricular volume, and aortic pressure and flow during the cardiac cycle?
What normally causes cardiac valves to open and close?
Why is the pressure gradient across a valve normally very low (just a few mmHg)?
When during the cardiac cycle are the first (S₁), second (S₂), third (S₃) and fourth (S₄) heart sounds heard, and what causes these sounds?
What are murmurs and what produces the audible sounds?
What is the difference between systolic and diastolic murmurs with respect to when they are heard during the cardiac cycle?
What is the difference between a stenotic valve and insufficient valve?
What valve defects are associated with systolic murmurs?
What valve defects are associated with diastolic murmurs?
What determines the magnitude of the pressure gradient across a stenotic valve?
What is Poiseuille's equation and how does it relate to the pressure gradient across a valve?
What is turbulent flow and how does it differ from laminar flow?
How is turbulence related to flow velocity, valve orifice area, and blood viscosity?
What is the effect of exercise (increased cardiac output) on the pressure gradient across a stenotic valve?
How does aortic stenosis alter the left ventricular pressure-volume loop?
How does mitral stenosis alter the left ventricular pressure-volume loop?
How does aortic regurgitation alter the left ventricular pressure-volume loop?
How does mitral regurgitation alter the left ventricular pressure-volume loop?
What valve defects can increase left atrial and pulmonary capillary wedge pressures, and what is the consequence of elevating these pressures?
How can valve defects lead to reduced exercise capacity and exertional dyspnea?

Revised 11/03/06