VALVULOPATIAS Fisiopatologia

VALVULOPATÍAS Dr. Fernando Verbal Cardiología

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Características Válvulas Normales • Permiten un flujo de sangre unidireccional. • Sus hojuelas tienen un aspecto fino y traslúcido. •  Tienen pocos vasos sanguíneos. • Se nutren por difusión. •  Tienen un cierre adecuado.

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Generalidades Patología Valvular Estenosis (estrechez) Insuficiencia (regurgitación) Combinación de ambas (enfermedad)

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Valvulopatías: Soplos característicos Soplos sistólicos : Estenosis Aórtica, Estenosis Pulmonar, Insuficiencia Mitral, Insuficiencia  Tricuspídea.

Soplos diastólicos: Estenosis Mitral, Estenosis Tricuspídea,

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Causas de Valvulopatías Enfermedad Reumática. Endocarditis infecciosa. Defectos Congénitos.  Trastornos por

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Fisiopatología de la Enfermedad Reumática • Faringitis causada por un streptococo ß-hemolítico A • Respuesta inmune con formación de anticuerpo que reacciona en forma cruzada con la válvula cardiaca.

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Patogénesis Endocarditis Vascular endothelium endothelium

Mucous membranes/ Other colonized tissue

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Valvulopatías: Valvulopatías: Etiología General Hereditaria-Congénita :  Trastornos del colágeno; Cardiopatías • Hereditaria-Congénita Congénitas. : Fiebre Reumática; SIDA; Sífilis; Kawasaki, • Inflamatorias Endocarditis Trombótica no bacteriana, Endocarditis Infecciosa; Auto-inmunitarias.

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Causas de Valvulopatías Específicas • Insuficiencia Mitral • Estenosis mitral

• Prolapso Mitral; IAM; MCD; Calcificación del anillo Mi. Endocarditis. • Reumática

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Factores que influyen en la variabilidad

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Evaluación Clínica: Auscultación DIÁSTOLE

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Historia natural

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Graduación de severidad EM leve:

área entre 1.5-2 cm2.

EM moderada: área entre 1-1.5 cm2. EM severa:

área < 1 cm2.

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Estenosis Mitral: Tratamiento Medidas generales: 

Profilaxis enfermedad reumática y endocarditis infecciosa.

Disminución de volumen: 



Dieta hiposódica. Diuréticos.

Disminución de frecuencia cardiaca:

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Tratamiento: Tratamiento: Valvuloplastía percutánea Mitral • Primer procedimiento realizado en 1982. En Chile en 1987. • Excelentes resultados a corto y largo plazo en largas series. • Resultados similares a la comisurotomía quirúrgica. • Baja incidencia de complicaciones

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Valvuloplastía percutánea percutánea con Balón

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Estenosis Mitral: Tratamiento Quirúrgico Plastía Mitral.

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Insuficiencia Mitral Enfermedad Enfermedad Valvular Mixomatosa; Mixomatosa; Prolapso de VM. Consideradas Consideradas anomalías hereditarias del tejido conjuntivo)

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Anatomía Componentes del aparato mitral: (cualquiera de ellos produce Insuficiencia Mitral primaria)

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Mitral Valve - Normal

Insuficiencia Mitral Mild Scarring Advanced Scarring

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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