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Note: Mitral valve = bicuspid valve = aortic valve. And tricuspid valve = right atrioventricular valve.

Blood flows through the aortic valve --> aorta --> arteries --> arterioles --> capillaries in the great toe --> venules --> veins --> superior and inferior venacavae --> right atrium --> tricuspid valve.

This above is incorrect. The Mitral valve is the bicuspid valve but it is NOT the aortic valve.

So blood flows from the Mitral valve to the left ventricle to the aortic valve to the aorta. The rest appears correct.

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Q: Trace the blood from the mitral to the tricuspid valve by the way of the great toe?
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Rheumatic heart disease is caused as a sequel of beta haemolytic streptococcal infection. It affects the mitral valve most commonly. All the four heart valves originate from the same embryonic cell rest. The golden question is why the mitral valve in involved most commonly and not others. The reason is very simple. You have to look at the hydrodynamics of the blood flow through the cardiovascular system. Blood flows in similar fashion through right and left side of the heart. But the pressure in left side is much more than in the right side. It is about 120 mm of mercury in the left and about 25 mm of mercury in the right side in the heart. So when the left ventricle contracts, blood strike on the mitral valve with much greater force than it strikes the tricuspid valve as the valve closes down. So the antibody/ antibodies in the blood also strike with great force on the mitral valve. So it is most commonly involved. The second most common valve is valve in aortic valve. Here again the pressure is high. About 120 mm of mercury. But there is way out for the blood to flow away. So the pressure is not maintained in sustained way. The strike of the blood against the valve is not as consistent. The third valve to get affected is tricuspid valve. Here the pressure is less as compared to the left side of the heart. The forth valve is pulmonary valve. Here the cavity is not tightly closed. Blood can flow away. So it is least affected.


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