Valve Disorders Flashcards
Rheumatic fever
Acute multi system inflammation
Cause of RF
Untreated Streptococcus pharyngitis - didn’t finish antibiotic or misdiagnosed
40% of RF can cause?
Pancarditis (all 3 layers of the heart)
RF inflammation can cause?
Fibrous, scar tissue in myocardium
Rheumatic endocaditis
Valves are affected
Modified Jones Criteria?
Diagnosis for Rheumatic fever
Which valve is most affected by Chronic Rheumatic carditis?
Mitral but aortic and tricuspid can be affected
Txn for RH?
Penicillin (treat infection) and NSAIDS, Colchicine
Nursing interventions
- Health promotion and disease prevention
- Seek medical attention if you have strep throat
- Education on meds and finishing the meds
- Rest and relieve pain
- Admin penicillin
Type of Valve Diseases
Stenosis and Regurgitation
Stenosis
Narrowing - impairing forward blood flow
Regurgitation
Incomplete closure - back flow of blood
Causes of valvular heart disease?
RH
AIDS
Congenital conditions (born)
Older Adults w/ cardiovascular diseases
Infective endocarditis
Mitral valve stenosis most commonly from?
RHD (mostly)
Congential
RA
SLE (lupus)
What happens in mitral valve stenosis?
LA pressure increases due to increased volume (pressure overload)
Pulmonary vascular resistance increases because of hypertrophy in vessel
S/S of mitral stenosis
DOE, fatigue, Afib, low pitched diastolic murmur at Apex
Mitral regurgitation causes
MI (mostly), RHD, MVP, IE, ischemic papillary muscle dysfunction
S/S in Acute MR
Pulmonary edema and cardiogenic shock
S/S of chronic MR
LV failure, S3, Murmur - surgery needed to prevent LV failure or Pulmonary hypertrophy
Acute MR intervention
Needs quick intervention to cath lab or surgery for valve repair or replacement
Mitral prolapse can cause
Mitral regurgitation, HF, infectious endocarditis
S/S of mitral prolapse
Most are asymptomatic, 10% shows signs of
Palpitations
Dyspnea
Chest pain
Activity intolerance
Syncope
Murmur
Mid-systolic click
Management of mitral prolapse
- Beta blocker
- Stay well hydrated
- Exercise
- Avoid caffeine and stimulants
- Antibiotics prophylaxis
Aortic stenosis usually seen from?
- Congenital
- RF if from this leaflets stiffen and retract, resulting in stenosis
- Adult or 65 or older
Pathology of Aortic Valve
Blood flow is obstructed from LV to aorta during systole.
LV hypertrophy occurs so O2 demand increases
Disease progression results in- decreased CO, tissue perfusion, pulmonary hypertrophy and HF
S/S of Aortic valve stenosis
Angina, syncope, exertional dyspnea (LV HF), HF, systolic murmur, diminished or absent S2 and prominent S4
Aortic Valve regurgitation?
Blood flow from the aorta into the LV during diastole - which will cause hypertrophy due to overload
Acute Aortic valve regurgitation can cause?
Cardiovascular collapse
Profound dyspnea
Chest pain
Hypotension
Cardiogenic shock
This is a MEDICAL EMERGENCY
Chronic Aortic Valve Regurgitation can?
Remain asymptomatic for years.
Heart sounds- soft S1, S3 or S4, soft, high pitched diastolic murmur. Low pitched murmur in severe.
In Tricuspid and Pulmonary Valve diseases?
Stenosis is most common
Tricuspid stenosis we see?
RA enlargement elevated systemic venous pressure
Tricuspid stenosis seen from?
IV drug users and RH
Pulmonic stenosis is seen from?
Congenital
Pulmonic stenosis results in?
RV hypertrophy and HTN
How to diagnosis Valve Heart Disease?
- History and Physical - Did they have Rheumatic fever as a child? Have you had a sore throat?
- Heart sounds, CXR, EKG
- Most definite is Echo
- Heart cath
Treatment for Valves?
- Depends on severity
- Treat symptoms and prevent exacerbations
- Meds like vasodilators, inotropes, BB, diuretics, low Na
- Surgery- valvuotomy is procedure of choice - to repair closed or open.
Closed - transventricular dilator is inserted
Open- cardiac bypass - Valve replacement with prosthetic
