Valve Disorders (Module 4) Flashcards
Valve Disorders Patho
mitral stenosis
mitral regurgitation/prolapse
aortic stenosis
aortic regurgitation
Valve Disorders Causes
congenital heart disease
rheumatic heart disease
infective endocarditis
ischemia caused by ACS
MV Stenosis
valve thickens and calcifies, can’t open normally leading to increased workload of cardiac chamber pumping through the stenosed valve
left atrium dilated and hypertrophies b/c of an increased workload, leading to increased pulmonary pressure and RV hypertrophy with the subsequent development of HF
MV Insufficiency (Regurgitation)
can’t close normally with each contraction, the LV forces blood back into LA
left atrium dilated and hypertrophies b/c of an increased workload, leading to increased pulmonary pressure and RV hypertrophy with the subsequent development of HF
AV Stenosis
can’t open normally leading to increased afterload work of the LV as it attempts to propel blood through a narrowed valve
“wear and tear” with aging
LV dilates and hypertrophies as a result of increased pressure, precipitates LV failure
AV Insufficiency/Regurgitation
can’t close normally leading to increase afterload work of LV as blood leaks back into LV after contraction
LV dilates and hypertrophies as a result of increased pressure, precipitates LV failure
MV Disorders S/S
exertional dyspnea progressing to orthopnea
progressive fatigue caused by decrease in CO
cardiac murmur (diastolic), palpitations
systemic embolization
A Fib (maintaining CO)
AV Disorders S/S
syncope and vertigo
nocturnal angina with diaphoresis (interferes with coronary artery filling)
dysrhythmia, systolic murmur in stenosis
dyspnea and increasing fatigue, HF (exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea)
w/severe disease, bounding arterial pulse and widened pulse pressure; client feels palpitations and nocturnal angina with diaphoresis
high pitched, blowing decrescendo diastolic murmur with aortic regurgitation can be heard
Valve Disorders Risk Factors
CAD, HTN, HF
rheumatic heart disease/inflammatory infections
IV drug use
age/congenital abnormalities
Valve Disorders Labs/Diagnostics
same as HF
Valve Disorders Procedures
conservative medical management
valve repair (percutaneous transluminal balloon valvuloplasty (PTBV) or annuloplasty)
PTBV
repair of valve leaflet under general anesthesia
primarily treats stenosis
Annuloplasty
corrects valve regurgitation by repairing enlarged annulus
Mechanical Heart Valves
lasts longer (20-30 yrs)
increased risk of thromboembolism
life long anticoagulant therapy to prevent thrombus
Biological Heart Valves
less thrombogenic
don’t last as long (7-10 yrs)
Valve Disorders Complications and Nursing Care
murmurs
HF (maintaining homeostasis and preventing development of HF; pt advised to avoid excessive fatigue and should be assessed according to lvl of activity intolerance)
sudden cardiac death risk (ICD)
