PRECIPITATING FACTORS:

PREDISPOSING FACTORS:
History of Group A Beta
Female
Hemolytic Strep throat
5 – 15 y/o
infection

↑ Resistance to flow / ↑ cardiac

workload Strep throat
Group A Beta Hemolytic
infection

↑ Left atrial &

Inflammation process ↑on
Pulmonary
the layersvenous
ventricular end-
of the heart pooling
diastolic pressure

Impaired ability to
Abnormal humoral & cell-mediated
Left atrial dilation move unoxygenated
response to streptococcal cell
blood from systemic
membrane antigens
to pulmonary
Antigens bind to receptors circulation
of the
↓ Ventricular filling
heart which begins autoimmune
Accumulation of blood
response
into the systemic
Crackles venous system
Pulmonary congestion
Dyspnea Endocardial inflammation
↑ Right atrial &
ventricular end-
Retention of fluid in diastolic & systemic
Swelling of valve venous
peripheral tissues leaflets pressure Heart murmur
Congestion of the Neck vein
Fluid shifting from viscera & peripheral engorgem
Small bacterial
intravascular to vegetations form on
tissues ent
pleural spacethe valve tissue
CXR Result Blood backs up in the
(08/27/10): hepatic vein
Bilateral Rough eroded areas of the valve
Pleural effusion
attract platelets
minimal Impaired liver function Jaundice
pleural Icteric sclera
effusion
Adherence and formation of platelet-
fibrin clumps

LEGEND: Scarring and shortening of the valve

Disease Process
Mitral Valve
Signs & Symptoms ↓ Elasticity / stiffness of the valve
Stenosis

Leading to
↑ Resistance to flow / ↑ cardiac
Co - existing workload