Heart failure and cardiac inflammatory disorders Flashcards
Which valves are AV valves?
mitral and tricuspid, referred as leaflets
which valves are SL valves?
aortic and pulmonic, referred as cusps
what is mitral valve regurgitation?
when blood flows from LV back to left atrium because the mitral valve does not close properly
What are the clinical manifestations of mitral valve regurgitation?
SOB w exertion, weakness, palpitations, med-high pitched blowing systolic murmur, often caused by rheumatic fever
What is Aortic regurgitation?
Back flow of blood into the left ventricle from the aorta due to the aortic valve not closing correctly
what are the clinical manifestations of aortic regurgitation?
SOB w exertion, orthopnea, paroxysmal nocturnal dyspnea, forceful heartbeat in head/neck, med- high pitched blowing diastolic murmur
what is mitral stenosis?
decreased blood flow from left atria to left ventricle due to valve not opening completely
what are the clinical manifestations of mitral stenosis?
dyspnea w exertion, low exercise tolerance, dry cough, hemoptysis, low pitched rumbling diastolic murmur
pt will not show s/s until 1/2-1/3 of blood flow is decreased
what is aortic stenosis?
narrowing orifice between left ventricle and aorta
what are the clinical manifestations of aortic stenosis?
Dyspnea on exertion, angina, pulmonary edema, syncope, decreased BP, loud harsh systolic murmur, s4 sound
what is a comissurotomy?
type pf valvuloplasty used for mitral valve stenosis, involves separating fused leaflets
what are the risks of a mechanical valve replacement?
last longer, but higher risk of thromboembolism, requires long term anticoagulation (Mitral INR: 2-3.5, Aortic INR 1.8-2.2)
what is mitral prolapse?
stretching of valve leaflet that backs into atrium during systole
what is the most common cardiomyopathy?
dilated cardiomyopathy
what is dilated cardiomyopathy?
enlarged LV from heart muscle stretching and becoming thin, leads to impaired contractility
what is hypertrophic cardiomyopathy
autosomal genetic disorder that leads to increased heart size which leads to diastolic failure, genetic testing for 1st relatives if pt is positive)
clinical manifestations of cardiomyopathy
narrowing pulse pressure and pulsus paradoxus (systolic pressure decreases upon inspiration, HF signs as disease progresses
What is infective endocarditis?
caused by streptococcus viridian and staph aureus, leads to vegetation that adheres to valves
clinical manifestations of infective endocarditis
fever, murmur, myalgia
cutaneous signs of clustered petechiae, splinter hemorrhages, osler’s nodes (on thumb) and Janeway lesions (palm of hand)
medical management for infective endocarditis
abx therapy for 2-6 weeks
Nursing management for myocarditis
place patient on bedrest, avoid NSAIDS since it increases viral replication and increases cardiac injury, extra sensitive to digoxin
what is dressler’s syndrome
pericarditis that occurs 10-12 months after acute MI, s/s include chest pain worsening with inspiration and pericardial friction rub
Stage A Heart failure
high risk for developing left ventricular dysfunction without structural heart disease or s/s of HF
stage B heart failure
pt with left ventricular dysfunction or structural heart defect who has not developed s/s of HF
Stage C of heart failure
Pt with left ventricular dysfunction or structural heart defects that has current or had s/s of HF
Stage D of Heart failure
pt with refractory end stage HF requiring intervention
nursing management of Pulmonary Edema
rebreather mask, furosemide, NTG, position pt upright with legs dependent, monitor I/O,
what is the first sign of fluid overload with pulmonary edema
auscultating fine crackle in posterior base of lungs
when should patient talk to doctor about weight change if they have HF
weight change of 2lbs a day or 5lb a week is not normal
what does an echocardiogram indicate
determines EF% and confirms dx of HF, normal ef% is 55-65
