[PT2021] Question

[Crouch, Rebecca H]

Hi Everyone,

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.

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.

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, will be the more traditional profile of aortic stenosis and resultant left ventricular hypertrophy. Reasons AS typically occur in the adult are: chronic long-term hypertension, 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.

Please let me know if you have other questions.

Dr. Crouch


________________________________
From: Kojima, Jackson <jkkojima0924 at email.campbell.edu>
Sent: Friday, May 1, 2020 11:18 AM
To: Crouch, Rebecca H <rcrouch at campbell.edu>
Subject: Re: Question

It is on the Congenital Heart Defects Powerpoint on slide 16!

Thank you!

Jackson Kojima

On Fri, May 1, 2020 at 10:56 AM Crouch, Rebecca H <rcrouch at campbell.edu<mailto:rcrouch at campbell.edu>> wrote:
Hi Jackson,

Thanks for bringing that to my attention.  Which ppt is that on and I will review and get back to you shortly??

Dr. Crouch
________________________________
From: Kojima, Jackson <jkkojima0924 at email.campbell.edu<mailto:jkkojima0924 at email.campbell.edu>>
Sent: Thursday, April 30, 2020 8:20 PM
To: Crouch, Rebecca H <rcrouch at campbell.edu<mailto:rcrouch at campbell.edu>>
Subject: Question

Hey Dr. Crouch,

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?


Thank you,

Jackson Kojima
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