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Surgery

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Thyroid & Adrenal

Question
55 out of 99
 

What valvular lesion is most commonly found in a patient with Ehlers – Danlos syndrome?



A Mitral stenosis
B Mitral insufficiency

C Aortic stenosis
D Aortic insufficiency

Ans. D Aortic insufficiency (Ref: Schwartz :Principles of surgery 5th edition page no. 885-886)

a. A variety of the diseases produce aortic insufficiency.

b. Inflammatory disease is a frequent cause.

c. The most common one at present is bacterial endocarditis.

d. Bacterial endocarditis produces destruction or perforation of valve cusp leading to the aortic insufficiency.

e. Collagen vascular diseases are commonly associated with aortic insufficiency, Ehler –Danlos syndrome is a collagen vascular disease.

f. It produces myxomatous degeneration of the valve so called the floppy valve.

g. Degenerative vascular disease is a manifestation of fibroelastic deficiency or myxomatous degeneration that produces thin and elongated valvular tissue.

h. The aortic valve leaflets sag into the ventricular lumen, often with no other tissue abnormality, producing central aortic insufficiency.

i. Annular ectasia is a collagen disease associated with aaortic insufficiency.

j. This is seen in the most extreme form with the classic Marfan’s syndrome with extensive cystic medial necrosis of the aorta.

k. Aortic insufficiency develops as a result of the dilatation of the aortic ring.

l. A dissecting aneurysm too produces insufficiency by dissection of the aortic valve with detachment and prolapsed of the valve cusp.

m. In aortic insufficiency, blood regurgitates into the left ventricle during the diastole.

n. It leads to the dilatation of the heart.

o. The gradual dilatation leads to production of some of the largest heart seen in clinical cardiological cases.

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