Fish mouth stenosis in rheumatic hea disease is due to which of the following mechanisms?
Correct Answer: Calcification and fibrosis bridging across valvular commissures
Description: Fish mouth stenosis in RHD is manifestation of Chronic RHD involving mitral valve which is due to calcification and fibrosis bridging across valvular commissures. RHD is viually the only cause of mitral stenosis. Acute and chronic rheumatic hea disease. A) Acute rheumatic mitral valvulitis superimposed on chronic rheumatic hea disease. Small vegetations (verrucae) are visible along the line of closure of the mitral valve leaflet (arrows). Previous episodes of rheumatic valvulitis have caused fibrous thickening and fusion of the chordae tendineae. B) Microscopic appearance of an Aschoff body in a patient with acute rheumatic carditis. The myocardium exhibits a circumscribed nodule of mixed mononuclear inflammatory cells with associated necrosis; within the inflammation, large activated macrophages show prominent nucleoli, as well as chromatin condensed into long, wavy ribbons (caterpillar cells; arrows). C/D). Mitral stenosis with diffuse fibrous thickening and distoion of the valve leaflets and commissural fusion (arrows, C), and thickening of the chordae tendineae (D). Note neovascularization of anterior mitral leaflet (arrow, D). E). Surgically resected specimen of rheumatic aoic stenosis, demonstrating thickening and distoion of the cusps with commissural fusion. Comparison of the four major forms of vegetative endocarditis. The rheumatic fever phase of rheumatic hea disease (RHD) is marked by small, way vegetations along the lines of closure of the valve leaflets. Infective endocarditis (IE) is characterized by large, irregular masses on the valve cusps that can extend onto the chordae. Nonbacterial thrombotic endocarditis (NBTE) typically exhibits small, bland vegetations, usually attached at the line of closure. One or many may be present. Libman-Sacks endocarditis (LSE) has small or medium-sized vegetations on either or both sides of the valve leaflets.
Category:
Pathology
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