Exam 1: Chapter 33 - Valvular Heart Disease Flashcards
What is an abnormality or dysfunction of any of the hearts four valves?
Valvular heart disease
What valves are on the left side of the heart?
Mitral and aortic valves
What valves are on the right side of the heart?
Tricuspid and pulmonic valves
What valve dysfunction occurs secondary to endocarditis or IV illicit drug use and is rare?
Tricuspid valve dysfunction
What does valve dysfunction affect?
the efficiency of the heart as a pump and reduced stroke volume
What can valve dysfunction lead to overtime?
remodeling of the heart itself (hypertrophy) and heart failure
What is health promotions and disease prevention for valvular heart disease?
- prevent/treat bacterial infections
- consume diet low in Na and follow fluid restrictions to prevent heart failure
- control chronic illness
- increase activity/exercise to boost HDL levels
What are the two classifications for valvular heart disease?
- stenosis: narrowed opening impedes blood moving forward
- insufficiency/improper closure: some blood flows backwards (regurgitation)
What is congenital valvular heart disease?
can affects all four valves and cause either stenosis or insufficiency
What is acquired valvular heart disease?
can be classified as either:
- degenerative disease
- rheumatic disease
- infective endocarditis
What is acquired degenerative valvular heart disease?
due to damage over time from mechanical stress, atherosclerosis, and hypertension and most common in developed countries
What is acquired rheumatic valvular heart disease?
gradual fibrotic changes, calcification if valve cusps and most common in developing countries
What is acquired infective endocarditis?
infectious organisms destroy the valve. streptococcal infections are a common cause
what is a primary risk factor for mitral stenosis and insufficiency?
rheumatic fever
what is marfan syndrome?
a connective tissue disorder that affects the heart and other areas of the body
in older adults, what is the predominant cause of valvular heart disease?
degenerative calcification and atherosclerosis, papillary muscle dysfunction, and infective endocarditis
T/F: clients who have valvular heart disease often do not have manifestations until late in the progression of the disease
true
What helps to determine what valve is involved/damaged?
- a murmur
- echocardiogram
What does a chest x-ray show in terms of valvular damage?
chamber enlargement with stenosis and insufficiencies, and pulmonary congestion
What does a 12-lead EKG show in terms of valvular damage?
chamber hypertrophy
What does a transesophageal echocardiogram (TEE) show in terms of valvular damage?
provided visualization of the mitral and aortic valves and can be used intraoperatively during valve replacement and repair
What test assesses the impact of the valve problem on cardiac functioning during stress?
Exercise tolerance testing/stress echocardiography
What test determines ejection fraction during activity and rest of the heart?
radionuclide studies
what test is used to evaluate the coronary arteries and the degree of atherosclerosis?
angiography
What might the heart rhythm appear to be in a pt with valvular heart disease?
irregular, bradycardic, w/ murmur
What medications are used for valvular heart disease?
- diuretics
- afterload-reducing agents
- inotropic agents
- anticoagulants
Why are afterload-reducing agents given to pts with valvular heart disease?
they help the heart pump more easily by alternating the resistance to contraction
- ace inhibitors
- beta blockers
- calcium channel blockers
Why are inotropic agents given to pts with valvular heart disease?
they increase contractility and thereby improve cardiac output
- digoxin
What is post surgery care for any type of procedure for valvular heart disease?
- care for eternal incision
- limit activity for 6 weeks
- report fever
What are therapeutic procedures for valvular heart disease?
- percutaneous balloon valvuloplasty
- valve replacement
- miscellaneous surgical management
What is the goal of surgery for valvular heart disease?
Improve quality of life rather than prolong life
What consists of a percutaneous balloon valvuloplasty?
opens up aortic or mitral valves affected by stenosis
What does a valve replacement consist of?
replacement of damaged heart valves,
mechanical valves require lifelong anticoagulant therapy,
and tissue valves need to be replaced every 7-10 years
When should pt report to the provider who has valvular heart disease?
gain of 3lb in one day or 5lb in one week
What is the main complication for valvular heart disease?
Heart failure
