valvular disorders Flashcards
what are the 2 things that happen with valvular disorders?
-valve balloons into left atria (MVP)
-valve no longer seals properly (MVR/AVR)
what is MVP (mitral valve prolapse)
valve balloons into left atria
what is MVR/AVR (mitral/aortic valve regurgitation)
valve no longer seals properly
how will a client with a valvular disorder present in the beginning?
-asymptomatic
-arrhythmia
-dizzy/lightheaded
how will a client with a valvular disorder present as it worsens?
-SOB / dyspnea
-fatigue
-hemoptysis
what is corrigan’s pulse?
a pulse that is forceful and then suddenly collapses
what is a corrigan’s pulse specific to?
aortic regurgitation
what is a heart murmur (MVR)
forceful backflow of blood
what is the most common cause of valvular disorders?
weakened papillary muscles and/or chordae tendinae
what are some other causes of valvular disorders?
-viral/bacterial infection
-CAD
-autoimmune disorders
-congenital malformation
what labs are used to diagnose valvular disorders
-BNP
-CBC/BMP
-echo
-EKG
-stress test
-angiogram
-strep culture
what meds are used for valvular disorders?
-beta blockers
-diuretics
-ACE-I
-blood thinner
-antiarrhythmics
what beta blocker is used for valvular disorders and why?
metoprolol, decrease HR and increase contractility
what diuretic is used for valvular disorders and why?
furosemide to remove fluid
what ACE-I is used for valvular and why?
lisinopril because it blocks the kidneys demand and stops constricting
what blood thinners are used for valvular
ASA (baby aspirin)
warfarin
what antiarrhythmics are used for valvular
sotalol, amiodarone, flecanide
what is a transcatheter aortic valve replacement (TAVR)
replacement of the aortic valve through the heart vessels
mechanical vs. bioprosthetic valve
mechanical = man-made for younger people, need to take coumadin (hear clicking), lasts longer
bioprosthetic = on blood thinners for less of a time, tissue/valve comes from animal, lasts shorter
what is the process of repairing a valve?
ROSS procedure
complications from valve replacement and repair
-arrhythmias and CHF
what is the lifespan if a bioprosthetic valve
<60 years = 5-10years
>70 = 15-29 years
what is the disease process of the heart?
cardiomyopathy
describe hypertrophic cardiomyopathy
-thickened wall
-decreased filling
-reduced cardiac output
-CHF
is hypertrophic cardiomyopathy reversible?
if its viral, yes
describe dilated cardiomyopathy
-large ventricle (more capacity)
-decreased contraction
-reduced cardiac output
-CHF
what are causes of a-fib
-heart abnormalities
-CAD / MI
-sick sinus syndrome
-sleep apnea
-lung disease / viral infections
in a-fib, the heart beats _____
irregularly
what is an ectopic beat
not normal, shouldn’t happen
in a-fib, there are ____ impulses to the ventricle and ____ cardiac output
fewer, less
agitation in a-fib leads to ______
clots!!!!
a-fib leads to a ______% increased chance of stroke
500
how will a client with a-fib present?
-palpitations
-SOB
-weakness
-confusion/anxiety
-CP
labs and tests used to diagnose a-fib?
holter monitor
-coags
-CBC/BMP
-troponin
-BNP
-CXR and echo
what meds are used for a-fib?
-anticoagulants
-antiarrhythmics
-beta-blockers
-calcium channel blockers
what anticoagulants are for a-fib
warfarin, clopidogrel
what antiarrhythmics are for a-fib?
amiodarone, flecainide, sotalol
what beta-blockers are for a-fib
metoprolol, propranolol, atenolol
what calcium channel blockers are for a-fib
diltiazem, verapamil
what are acute interventions for a-fib with RVR?
cardioversion
what is a cardioversion and how will it effect the patient?
stop heart and restart it, sedate
the patient won’t remember. The ectopic beat wants to be the leader
what are surgical interventions for a-fib
-catheter ablation
-maze procedure
-watchmans device
what are some triggers of a-fib?
-caffeine
-OTC cough meds
-sleep deprivation, illness
-stress
-dehydration
-hormones
-smoking
what are primary causes of HTN?
idiopathic - don’t know the cause
what is the secondary cause of HTN?
renal diseases
why do renal diseases increase BP?
excess fluid raises BP
what are some miscellaneous causes of HTN?
-dyslipidemia
-obesity/sedentary
-DM
-HF/CAD/sickle cell
-meds / illegal drugs
how will a client with HTN present?
asymptomatic (silent killer)
complications from HTN?
-CVA
-MI
what kind of meds are used for HTN?
-thiazide diuretics
-ACE-Is
-ARBs
-CCBs
-beta blockers
-combo meds
what thiazide diuretics are used for HTN?
hydrochlorothiazide
what ACE-Is are used for HTN?
lisinopril (stops constriction)
what ARBs are used for HTN?
losartan
what CCBs are used for HTN
amlodipine, diltiazem (dilate smooth muscle, decreasing BP)
what beta blockers are used in HTN?
metoprolol
what combo meds are used in HTN?
losartan and HCTZ
you should monitor BP with HTN at the ___________
same time every day
