Aortic valve

1. Aortic stenosis
Causes
● Bicuspid valve - common in Europe, usually associated with calcification
● Calcification
● Rheumatic heart disease - common in rest of the world

2. Aortic regurgitation
Causes
1. Valvular
a. Infective endocarditis
b. Rheumatic heart disease
c. Congenital bicuspid valve
d. Aortic valve calcification
e. Myxomatous degeneration of aortic valve
2. Aortic root
a. Dilated aortic root - Marfans syndrome, Ehler Danlos syndrome
b. Dilatation secondary to hypertension
Mitral valve

1. Mitral stenosis
Causes ● Rheumatic heart disease

2. Mitral regurgitation
Causes
● Mitral valve prolapse
● Dilated cardiomyopathy
● Ischemic heart disease
● Papillary muscle rupture
Tricuspid valve

1. Tricuspid stenosis

Causes
● Rheumatic heart disease (thickened valve leaflets)
● Carcinoid syndrome (normal valve leaflets)
● Valve thickening and calcification
● Obstruction due to thrombus or tumor

2. Tricuspid regurgitation

Causes

Evaluation
Pulmonary valve

1. Pulmonary stenosis
Causes
● Part of congenital syndromes
○ Noonan’s syndrome
○ Tetralogy of Fallot
○ Rubella
● Acquired
○ Rheumatic fever
○ Carcinoid syndrome
● Subvalvular pulmonary stenosis may be associated with
○ Ventricular septal defect
○ Tetralogy of Fallot
○ Transposition of great arteries

2. Pulmonary regurgitation
Causes
● Carcinoid syndrome (with tricuspid valve disease)
● Endocarditis
● Congenital valve abnormalities
● Pulmonary valve prolapse
 Hipertensiunea pulmonară

V max RT PAPs Alte semne

HTP improbabilă <2.8 <36 -
HTP posibilă <2.8 <36 +
2.8-3.4 37-50 +/-
HTP probabilă >3.4 >50 +/-

*Alte semne: dilatare de cavități drepte, HVD, dilatarea AP, aplatizarea SIV, TAP scăzut

Timpul de accelerare în artera pulmonară

>120 Normal
<100 Sugerează HTP
<80 HTP severă
Fluxul din venele hepatice
FUS = IVTs/ (IVTs + IVTd)
FUS<55% - PAD > 8 mmHg
Ar>S – PAD crescută