VALVULAR HEART DISEASEDr. Poland Room 3-007, Sanger Hall, Phone: 828-9557E-mail: poland@hsc.vcu.eduDepartemen FisiologiFakultas Kedokteran Universitas Sumatera Utara

VALVULAR HEART DISEASEDysfunctional cardiac valves can be classified as:narrow (stenosis) or,leaky (regurgitation).

HEART MURMURAny disease process that creates turbulent flow in the heart or great vessels can cause a murmur

valvular lesions are the principal cause of heart murmurs

HEART MURMURHeart murmurs can be either systolic or diastolic. During systole, while the left ventricle is contracting, the aortic valve is open and the mitral valve is closed. Turbulent flow can occur either because of an incompetent mitral valve, leading to regurgitation of blood back into the atrium, or from a narrowed aortic valve.

HEART MURMURIn diastole, the situation is reversed, with filling of the left ventricle through an open mitral valve while the aortic valve is closed. Turbulent flow occurs when there is narrowing of the mitral valve or incompetence of the aortic valve.

Tekanan di atrium kiri bertambah besar untuk mengisi ventrikel dengan adekuatOtot atrium kiri mengalami hipertrofiAtrium kiri tidak hanya berfungsi sebagai reservoir pasif tapi aktif mengisi darah ke ventrikelDilatasi atrium kiri akibat volume atrium kiri meningkat

Peningkatan tekanan dan volume atrium kiri tekanan vena pulmonalis dan kapiler meningkatKongesti paru Akibat resistensi vena pulmonalis meningkat, maka tekanan arteri pumonalis meningkat.Ventrikel kanan hipertrofi

Kerja ventrikel kiri maupun atrium kiri meningkatDinding ventrikel dilatasi dan akhirnya hipertrofiAtrium kiri dilatasi dan akhirnya hipertrofi

STENOSIS AORTAMeningkatnya resistensi terhadap ejeksi ventrikel, menyebabkan beban ventrikel kiri meningkat ventrikel kiri hipertrofiTitik kritis stenosis aorta, bila orificium katup aorta dari ukuran 3-4 cm2 menjadi kurang dari 0,5 cm2

INSUFISIENSI AORTABeban volume ventrikel kiri cukup berat Ventrikel kiri mengalami dilatasi dan hipertrofi

PATENT DUCTUS ARTERIOSUSPatent ductus arteriosus (PDA) is a congenital disorder in the heart where in a neonates ductus arteriosus fails to close after birth.ductus arteriosus (DA) is the vascular connection between the pulmonary artery and the aortic arch.

PATENT DUCTUS ARTERIOSUSIn normal newborns, the DA is substantially closed within 1224 hours after birth, and is completely sealed after three weeks.When the newborn takes its first breath, the lungs open and pulmonary vascular resistance decreases. After birth, the lungs release bradykinin to constrict the smooth muscle wall of the DA and reduce bloodflow through the DA as it narrows and completely closes, usually within the first few weeks of life

PATENT DUCTUS ARTERIOSUSpatent ductus arteriosus is associated with a continuous murmur because of a persistent connection between the pulmonary artery and the aorta.A patent ductus arteriosus allows a portion of the oxygenated blood from the left heart to flow back to the lungs by flowing from the aorta (which has higher pressure) to the pulmonary artery.

Tetralogy of Fallot (TOF, Latin: Train of Four) is a congenital heart defect which is classically understood to involve four anatomical abnormalities (although only three of them are always present).It is the most common cyanotic heart defect, and the most common cause of blue baby syndrome

Pulmonary stenosisOverriding aorta; an aortic valve with biventricular connection.Ventricular septal defect (vsd); hole between the two bottom chambers (ventricles) of the heartRight ventricular hypertrophy

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