heart valves - safari99

[ArchivalUser]

why in rheumatic fever jst mitral and aortic valves are involved?

[ArchivalUser]

no 1?

[ArchivalUser]

???

[ArchivalUser]

good.
u r going to see ds on exam.

[ArchivalUser]

left sied heart valves face higher pressure gradients and flows so get easily damaged in comparison to right sided valves

[ArchivalUser]

any other reason?like immuno?

[ArchivalUser]

safari99 - 02/13/09 11:00

good.
u r going to see ds on exam.


Is that a threat???

I will try with my notes open

1) - Strep pyogene is #1 for throat infections and only throat Strep causes Rheumatic Fever

2)- Strep is swallowed → lungs → returns via pulmonary vessels → MV (that is the reason MV is #1 followed by AV)

3)- Carditis “ MS >> AS/MS >> AS >> TS → MC.

4)- Since you are asking Immuno, what is an immunogen?

the body will form immune response to Strep and it™s own basement membrane, after the bacteria is gone an AUTOIMMUNE response will take place since it now has formed an immune response to œself basement membrane

Just to answer your threat(())

[ArchivalUser]

LOL
thanks for contribution okt3.
u rt most of the time here,but for point 2,if strep swallowed goes in stomach,wudnt it wud be invading rt side of heart 1st via portal vein to IVC to rt side hrt?so this way rt side valves 1st shud be affected ?BUT not.
and immuno involved here is- strep A has M-protein which is immunogenic and cross react with skin, heart tissue,valves,joints,kidney thats why all sign symptoms together sign in RF.
but why MC lft sided valves involved? turbulent flow?but then what flow is in rt side?what lft side as high pressure chamber means to lft side valves involvement?

[ArchivalUser]

I think the most appropriate answer to this question is that the symptoms are most commonly manifested on the left side of the heart. If you put both answers above together the true answer comes out. As we know Rheumatic fever is caused by an autoantibody that is "accidently" made when trying to fight a long term Strep pyogen infection. (that is why even though Penicillin will not kill the active infection as any quicker since most strains are resistant, it will prevent the immune complexes from forming later on and it is show in studies it decreases the incidence of Rheumatic fever) However, these autoantibodies have a predilict for certain tissues of the body, the heart valves being one of them. These cause the edges of the valve to become inflamed (hence why you get an endocarditis) this inflammation causes scaring and calcification(these are you STERILE VEGITATIONS.. NO BACTERIA) Now the left side of the heart is the "HIGH PRESSURE SIDE", the left ventricle reaches 110mmHg before ejecting into the aorta in a normal person in comparison to the right ventricle which only has to reach a maximum of 25mmHg. So imagine taking two hoses with running water and putting a zipllock bag over the ends and ziplocking it. One hose has really high pressure running through it(left ventricle) and the other has lower pressure (right ventricle) which ziplock is going to break first and start leaking water. Once it starts leaking what do you do to fix it you add tape (which is equivilant to the body repairing an injury by calcification and fibrosis. This continues ont the left side more than the right and the calcification's become larger and more noticeable and more symptomatic. Hence the HIGH PRESSURE VALVES (mitral and Aortic) are involved more.

Hope that helped good luck

[ArchivalUser]

thanks xahdum16x for input.
i read this similar thing yesterday what u explained but some journals, in some studies rt sided valves were fopund to be normal no such vegitations,just left sided are found to have such manisfestations.i agree it wud be on account of sign symptoms which appreas early in left sided valve involvement,whether its high pressure causing or in later ages MS causing pul.symptoms.but why left valves more specific to have such vegitation??????? sorry if i missed in ur explanation,can u pls tell?