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VALVULAR HEART

DISEASE
Departemen Fisiologi
Fakultas Kedokteran
Universitas Sumatera
Utara
Dr. Poland Room 3-007, Sanger Hall, Phone: 8289557

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

HEART MURMUR
Any 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 MURMUR
Heart murmurs can be either systolic or

diastolic.
During systole,
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,
valve leading
to regurgitation of blood back into the
atrium, or from a narrowed aortic valve.
valve

HEART MURMUR
In diastole,
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 adekuat
Otot atrium kiri mengalami hipertrofi
Atrium kiri tidak hanya berfungsi
sebagai reservoir pasif tapi aktif
mengisi darah ke ventrikel
Dilatasi atrium kiri akibat volume
atrium kiri meningkat

Peningkatan

tekanan dan volume


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

Kerja

ventrikel kiri maupun atrium


kiri meningkat
Dinding ventrikel dilatasi dan
akhirnya hipertrofi
Atrium kiri dilatasi dan akhirnya
hipertrofi

STENOSIS AORTA
Meningkatnya resistensi terhadap ejeksi

ventrikel, menyebabkan beban ventrikel


kiri meningkat ventrikel kiri hipertrofi
Titik kritis stenosis aorta, bila orificium
katup aorta dari ukuran 3-4 cm2 menjadi
kurang dari 0,5 cm2

INSUFISIENSI AORTA
Beban volume ventrikel kiri cukup

berat
Ventrikel kiri mengalami dilatasi dan
hipertrofi

PATENT DUCTUS
ARTERIOSUS
Patent 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
ARTERIOSUS
In 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
ARTERIOSUS
patent 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 stenosis
Overriding aorta; an aortic valve
with biventricular connection.
3. Ventricular septal defect (vsd);
hole between the two bottom
chambers (ventricles) of the heart
4. Right ventricular hypertrophy
1.
2.

Let it
beat!

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