<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=us-ascii">
<style type="text/css" style="display:none;"> P {margin-top:0;margin-bottom:0;} </style>
</head>
<body dir="ltr">
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
Hi Everyone, </div>
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
<br>
</div>
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
Jackson brought a question to my attention this morning that I thought everyone would benefit from hearing the explanation as he was the 2nd student to ask....I believe it was you, Katie who first brought this up.</div>
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
<br>
</div>
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
When I went back and looked at the slide, I believe my thinking was that a major impairment of any one of the major valves (Mitral and Aortic) of the heart may lead to ventricular hypertrophy on either side. The rationale being that the heart/lung circulation
is a tight circuit (not totally closed circuit, however). With that in mind, we sometimes see in high stage heart failure, especially in congenital heart abnormalities, that valve problems effect both the right and left side. These are the patients who end
up needing BiVAD (both right and left ventricular assist devices) or Heart Transplant.</div>
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
<br>
</div>
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
When you trace back the circuit from Aortic Stenosis, you can understand how the right ventricle may be effected in severe cases without surgical repair. However, in MOST CASES we associate Left Ventricular hypertrophy with Aortic Stenosis. Most of the patients
you will see in clinical practice, unless you work in peds with congenital heart defect cases,
<b>will be the more traditional profile of aortic stenosis and resultant left ventricular hypertrophy.
</b>Reasons AS typically occur in the adult are: chronic long-term hypertension, <span style="font-family: Verdana, Geneva, sans-serif; background-color: rgb(255, 255, 255); display: inline !important">plaque or scar tissue build up around the valve leaflets,
bacteria formation (and eventual scarring) around the valve due to severe infections (bacterial endocarditis), etc.</span></div>
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
<span style="font-family: Verdana, Geneva, sans-serif; background-color: rgb(255, 255, 255); display: inline !important"><br>
</span></div>
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
<span style="font-family: Verdana, Geneva, sans-serif; background-color: rgb(255, 255, 255); display: inline !important">Please let me know if you have other questions.</span></div>
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
<span style="font-family: Verdana, Geneva, sans-serif; background-color: rgb(255, 255, 255); display: inline !important"><br>
</span></div>
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
<span style="font-family: Verdana, Geneva, sans-serif; background-color: rgb(255, 255, 255); display: inline !important">Dr. Crouch</span></div>
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
<br>
</div>
<div style="font-family: Verdana, Geneva, sans-serif; font-size: 10pt; color: rgb(0, 0, 0);">
<br>
</div>
<div id="appendonsend"></div>
<hr style="display:inline-block;width:98%" tabindex="-1">
<div id="divRplyFwdMsg" dir="ltr"><font face="Calibri, sans-serif" style="font-size:11pt" color="#000000"><b>From:</b> Kojima, Jackson <jkkojima0924@email.campbell.edu><br>
<b>Sent:</b> Friday, May 1, 2020 11:18 AM<br>
<b>To:</b> Crouch, Rebecca H <rcrouch@campbell.edu><br>
<b>Subject:</b> Re: Question</font>
<div> </div>
</div>
<div>
<div dir="ltr">It is on the Congenital Heart Defects Powerpoint on slide 16!
<div><br>
</div>
<div>Thank you!</div>
<div><br>
</div>
<div>Jackson Kojima</div>
</div>
<br>
<div class="x_gmail_quote">
<div dir="ltr" class="x_gmail_attr">On Fri, May 1, 2020 at 10:56 AM Crouch, Rebecca H <<a href="mailto:rcrouch@campbell.edu">rcrouch@campbell.edu</a>> wrote:<br>
</div>
<blockquote class="x_gmail_quote" style="margin:0px 0px 0px 0.8ex; border-left:1px solid rgb(204,204,204); padding-left:1ex">
<div dir="ltr">
<div style="font-family:Verdana,Geneva,sans-serif; font-size:10pt; color:rgb(0,0,0)">
Hi Jackson,</div>
<div style="font-family:Verdana,Geneva,sans-serif; font-size:10pt; color:rgb(0,0,0)">
<br>
</div>
<div style="font-family:Verdana,Geneva,sans-serif; font-size:10pt; color:rgb(0,0,0)">
Thanks for bringing that to my attention. Which ppt is that on and I will review and get back to you shortly??</div>
<div style="font-family:Verdana,Geneva,sans-serif; font-size:10pt; color:rgb(0,0,0)">
<br>
</div>
<div style="font-family:Verdana,Geneva,sans-serif; font-size:10pt; color:rgb(0,0,0)">
Dr. Crouch</div>
<div id="x_gmail-m_-5783895484482802830appendonsend"></div>
<hr style="display:inline-block; width:98%">
<div id="x_gmail-m_-5783895484482802830divRplyFwdMsg" dir="ltr"><font face="Calibri, sans-serif" color="#000000" style="font-size:11pt"><b>From:</b> Kojima, Jackson <<a href="mailto:jkkojima0924@email.campbell.edu" target="_blank">jkkojima0924@email.campbell.edu</a>><br>
<b>Sent:</b> Thursday, April 30, 2020 8:20 PM<br>
<b>To:</b> Crouch, Rebecca H <<a href="mailto:rcrouch@campbell.edu" target="_blank">rcrouch@campbell.edu</a>><br>
<b>Subject:</b> Question</font>
<div> </div>
</div>
<div>
<div dir="ltr">Hey Dr. Crouch,<br>
<div><br>
</div>
<div>I just had a question about aortic stenosis. On the slide it says, "why does the right ventricle hypertrophy?" I was just wondering if the right ventricle hypertrophies as well as the left of just the left?</div>
<div><br>
</div>
<div><br>
</div>
<div>Thank you,</div>
<div><br>
</div>
<div>Jackson Kojima</div>
</div>
</div>
</div>
</blockquote>
</div>
</div>
</body>
</html>