Lecture 28 Flashcards
cause of mitral valve prolaps (MVP)
cause unknown in most patients. it is most often caused by myxomatous degeneration of valve leaflets. can be a genetic collagen disorder
long, thin extremities, dislocation of lenses and aortic aneurysm
marfan’s syndrome
MVP can occur as a result of:
- acute rheumatic fever
- ischemic heart disease
- various cardiomyopathies
- atrial septal defect
autoimmune disease resulting from streptococcus infection
acute rheumatic fever
not enough blood and oxygen supplied to the myocardium
ischemic heart disease
weakening of heart muscle or other functional problem
various cardiomyopathies
congenital opening between upper chambers of the heart
atrial septal defect
MVP can be mild or severe. it sometimes also leads to serious problems. these can include:
- mitral regurgitation
- endocarditis
- heart rhythm problems
- transient ischemic attack (TIA)
- stroke
usually causes no symptoms until it is severe
mitral regurgitation
heart valve gets infected
endocarditis
tachycardia- rarely a heart rhythm problem can cause sudden death, which when the heart suddenly stops beating
heart rhythm problems
similar to a stroke but the brain isn’t damaged
transient ischemic attack (TIA)
many people with MVP have no______
symptoms
some people experience symptoms such as:
chest pain, tachycardia, fainting or dizziness, palpitations, orthopnea
test used most often to check for MVP
echocardiogram
is MVP curable?
no
Medications that can be used to alleviate mild symptoms of MVP
- vasodilators
- digoxin
- anti-arrhythmic agents
- blood thinners
widen the blood vessels to decrease the amount of force and effort that the heart has to endure
vasodilators
use to strengthen the heart muscles for a stronger heart beat
digoxin
can be used to regulate heart rhythms
anti-arrhythmic agents
used to prevent blood clots from forming that can worsen the problem
blood thiners
more common in ______ between the ages of 15 and 30 years old and is usually benign
women
more severe cases are observed in older (>50) patients (often ______) and requires surgical treatment
men
there is an increased familial incidence for some patients, suggesting an autosomal form of ______________
inheritance
surgery is considered if _______ is severe and the valve is repaired or replaced
leakage
condition where decreased blood flow causes decreased tissue perfusion and O2 delivery
circulatory shock
caused by myocardial impairment (MI, congestive HF)
cardiogenic shock
loss of vasomotor tone, which leads to venous pooling (deep general anesthesia, spinal cord injury)
neurogenic shock
increased filtration across capillary walls, which leads to decreased circulating blood volume
septic/anaphylactic shock
obstruction anywhere in circulatory system that can cause a local decrease in blood flow
mechanical obstruction to blood flow
circulating blood volume decreased because of whole blood loss
hypovolemic shock
what causes hypovolemic shock?
- hemorrhage
- surgery
- burns
- trauma
- fluid loss associated with vomiting/diarrhea
signs and symptoms of hypovolemic shock
- thirst, nausea, anxiousness, weakness, light-headedness, dizziness
- low urine output and ark yellow urine
- increased HR and respiratory rate
- low or normal body temp
- decreased bicarbonate and pH (acidosis)
- mental status change or unconsciousness
- organ failure or multiple organ dysfunction syndrome (MODS)
what is the pathophysiology of hypovolemic shock?
circulatory function over time
compensatory mechanisms of hypovolemic shock
baroreceptors, chemoreceptors, norepineprhine, angiotensin II
treatment for hypovolemic shock
- fluid replacement
- maintain hemoglobin
- vasopressor therapy (dopamine, norepinephrine, phenylephrine, vasopressin)
