VALVULAR DISEASES

Mitral stenosis	Inflammatory	Almost always due to rheumatic fever (with 2° calcification)
Mitral regurgitation	Inflammatory	Rheumatic heart disease (less common cause now)
	structural	i) ruptured chordae tendinae - MI, secondary to: mitral valve prolapse, endocarditis, trauma ii) rupture or dysfunction of papillary muscles secondary to:- ischaemia, MI iii) dilatation of mitral valve annulus & left ventricle - congestive cardiomyopathies, iv) secondary to left atrial myxoma v) mitral valve prolapse - common & usually benign - in 6% of all healthy young females - familial tendency
	infective-	Infective endocarditis
Aortic stenosis	Congenital	Most common - ≤ 12% of population have bicuspid aortic valve
	degenerative	Senile degenerative calcification - (degeneration from base of valve to edge)
	inflammatory	Rheumatic heart disease - most common cause of AS in past (degeneration from edge of valve to base)
Aortic insufficiency	Degenerative	Connective tissue disease (eg Marfan’s)
	inflammatory	Rheumatic fever (common in past)
	infective-	Bacterial endocarditis - syphilis
	structural	Diseases causing dilatation of the aorta
Tricuspid stenosis	Inflammatory	Rheumatic heart disease [most common] - sle
	carcinoid	Metastatic lesions on tricuspid valve
Tricuspid regurgitation	Structural	Dilated right ventricle secondary to RVF [most common] which may be due to aortic or mitral valve disease
	infective	Drug abuse endocarditis
Pulmonic stenosis	Congenital	Most common
Pulmonic regurgitation	Structural	Pulmonary hypertension [most common]

Disease Type	Etiology	Valves Affected
INFLAMMATORY	· Rheumatic heart dx · SLE	ALL TS
STRUCTURAL	· Ruptured chordae tendinae - MI, secondary to: mitral valve prolapse, endocarditis, trauma · Rupture or dysfunction of papillary muscles secondary to:- ischaemia, MI · Dilatation of mitral valve annulus & left ventricle - congestive cardiomyopathies, · Secondary to left atrial myxoma	MR
	· Dx causing aortic dilatation	AR
	· Dilated right vent 2° RVF.	TR
	· Pulmonary HT.	PR
INFECTIVE	· Infective endocarditis · Syphilus	MR, AR AR
CONGENITAL		ALL
DEGENERATIVE	· Degenerative calcification · Connective tissue-marfans	AS AR
CARCINOID	· Right atrial tumours	TS