Term
| Where is the mitral valve? |
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Definition
| L side of the heart between the L atrium and ventricle |
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Term
| What can cause damage to the mitral valve? |
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Definition
| Untreated strep -> rheumatic fever! |
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Term
| What does damage to the mitral valve cause? |
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Definition
| mitral valve regurgitation and L sided backup |
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Term
| What happens when the blood backs up on the L side? |
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Definition
| Blood fills the L ventricle, atrium, lungs, then the right ventricle, right atrium |
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Term
| What are the 2 types of valvular disease? |
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Definition
Stenosis occurs when the opening of the valve is narrowed, and the forward flow of blood through the valve is reduced
Regurgitation occurs when valves do not close completely and blood flows backward through the valve |
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Term
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Definition
| Infection of the inside of the heart caused by IV drugs or untreated strep infections |
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Term
| What does an echocardiogram diagnose? |
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Definition
| valve motion and velocities, chamber sizes and function |
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Term
| What does a chest x ray diagnose? |
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Definition
| heart size, pulmonary congestion |
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Term
| What does an EKG diagnose? |
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Definition
| Ventricular hypertrophy, atrial abnormalities, conduction abnormalities, previous MI, ischemia |
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Term
| What is mitral valve stenosis? |
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Definition
| Narrowing of the mitral valve orifice which impedes filling of the left ventricle in diastole |
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Term
| What does mitral valve stenosis lead to? |
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Definition
more blood remains in LA, causing increase LA pressure, LA dilates, stagnation of blood in atrium can lead to clot formation
Increased pressure in LA causes back up to the pulmonary system, increased pulmonary venous pressure
RV contracts against increase pressure, with the RV and RA eventually enlarging |
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Term
| What is the major risk factor for mitral valve stenosis? |
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Definition
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Term
| What is mitral valve prolapse? |
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Definition
Systolic billowing of one or both leaflets into the left atrium during systole
Usually asymptomatic
Blood in LV backs up into LA |
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Term
| What is the treatment of MVP? |
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Definition
Tx: Beta blockers, calcium channel blockers
Can be repaired or replaced
No caffeine, and no alcohol |
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Term
| What is the most common cause of aortic stenosis? |
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Definition
valve calcification
Caused by narrowing of the orifice of the AV which leads to obstruction of the LV outflow tract |
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Term
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Definition
| The narrowing of the valve opening between the left ventricle and the aorta, resulting in obstruction of blood flow: |
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Term
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Definition
| A disorder of the myocardium (heart muscle) associated with mechanical and/or electrical dysfunction |
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Term
| What do all myapothies result in? |
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Definition
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Term
| What is dilated cardiomyapothy? |
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Definition
o Significant, irreversible dilation of the ventricles
o Poor blood flow thru atria and ventricles
o Enlarged left ventricle with reduced ejection fraction |
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Term
| How is dilated cardiomyapothy managed? |
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Definition
o Bedrest to reduce metabolic and oxygen consumption until improved.
o Diuretics reduce preload
o Meds to reduce afterload if no history of renal failure (Calcium channel blockers, ACE inhibitors) |
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Term
| What is the nursing management of a dilated cardiomyapothy ? |
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Definition
assessment for signs of worsening heart failure, dyspnea, congested lungs, peripheral edema, and the presence of abnormal heart sounds
o Administer oxygen, HOB ↑, ABGs, Potassium level if on diuretics. |
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Term
| What is valvular insufficiency? |
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Definition
| valve is unable to close sufficiently – blood leaks backwards. With increased severity, the heart has to pump harder to maintain cardiac output. “regurgitation” or “prolapse” |
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Term
| What is valvular stenosis? |
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Definition
| Valve opening is narrowed due to stiffening of the valve leaflets thus causing the heart to pump more vigorously to push blood through the stiff valve which leads to heart weakness and failure. |
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Term
| What is valvular sclerosis? |
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Definition
| Slightly narrowed, thickened, or roughened |
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Term
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Definition
| systolic pressure difference between the LV outflow tract and ascending aorta |
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Term
| What are the types of acquired VHD? |
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Definition
Rheumatic Heart Disease
Degenerative or Calcific
Endocarditis
Acute MI
Hypertension
Atherosclerosis
Carcinoid tumors
Systemic Diseases - RA, SLE
Syphilis
Methysergide (migraine tx), diet drugs
Radiation therapy |
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Term
| What are the symptoms of mitral valve stenosis? |
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Definition
| dyspnea on exertion (DOE), paroxysmal nocturnal dyspnea (PND), and atrial fibrillation |
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Term
| How is mitral valve stenosis managed? |
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Definition
Symptom Management
Diuretics
Atrial Fibrillation
RATE CONTROL -
Beta blockers - metoprolol
Calcium Channel Blockers - cardizem
Digoxin
Antiarrhythmics – Amiodarone
DCCV
Anticoagulation
SBE Prophylaxis for patients with hx. RHD
Surgery
Percutaneous Mitral Balloon Valvotomy (PMBV)
Mitral Commissurotomy
MVR |
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Term
| What are the sxs of mitral valve prolapse? |
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Definition
| fatique, dyspnea, lightheaded, palpitations, chest pain |
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Term
| Which valvular disorder has the highest mortality rate? |
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Definition
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Term
| What is the pathophys of aortic stenosis? |
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Definition
LV encounters chronic resistance to systolic ejection (afterload) – LV must generate higher pressure than the opposing pressure produced by the stiff valve
To compensate for the high afterload, the LV wall thickens (cocentric hypertrophy) strengthens LV systolic contraction to maintain adequate stroke volume and cardiac output
This forces the left atrium to operate with a “kick” to force blood to the ventricle due to the changes in pressure |
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Term
| What are the s/s of aortic stenosis? |
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Definition
-decreased exercise tolerance
-syncope
-angina
-heartfailure |
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Term
| How is aortic stenosis treated? |
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Definition
Surgical Replacement – AVR (mechanical or bioprosthetic)
TAVR
Angina – Bedrest, oxygen, nitrates, Beta Blockers
Syncope - ? Cause
Pulmonary Edema – digitalis, diuretics, ACE/ARB
Bridge Therapy - valvuloplasty |
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Term
| What is aortic regurgitation? |
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Definition
The backward flow of blood into the left ventricle from the aorta during diastole
Symptoms are related to increased stroke volume |
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Term
| What are the nursing considerations for a patient w. mechanical valve? |
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Definition
Assess for signs and symptoms of emboli and heart failure.
Care is similar to that of a patient recovering from coronary artery bypass surgery.
Patients are at risk for postoperative complications, including thromboembolism, infection, arrhythmias, and hemolysis. |
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Term
| What are the s/s of dilated cardiomyapothy? |
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Definition
| o Progressive fatique, weakness, SOB, DOE |
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