Valvular Heart Disease

Question 1

These are meant to allow blood, to go through from one place to another and then close off.

Answer 1

VALVES

Question 2

What is the normal function of the valves?

Answer 2

prevent any type of regurgitation or back flow from that blood going through

Question 3

What are the main problems in valvular heart disease?

Answer 3

1. Valves cannot perform properly
2. The issues that sufficient blood flow goes out from the heart

Question 4

Name all the valves, describe, and identify the function.

Answer 4

Atrio-ventricular valves
1. Trcuspid - RA&RV
2. Mitral - LA & LV
Closes together and produces “lub”

Semilunar valves
1. Pulmonic - RV & PA
2. Aortic - LV to the rest of the body through the aorta
Closes together and produces “dub”

Question 5

What are the 2 problems of valvular heart disease?

Answer 5

stenosis
regurgitation

Question 6

• Insufficiency to open and “stiff”
• Thickened stiff valves; problem in opening

Answer 6

stenosis

Question 7

Decreased blood flow coming down & Increased blood flow bouncing around causes…

Answer 7

turbulent blood flow

Question 8

• Insufficiency when closing
• Problem in closing; can close but can’t fully closed

Answer 8

Regurgitation

Question 9

If there is regurgitation, where does the blood goes?

Answer 9

blood turns back

Question 10

what are the causes of valvular hear disease?

Answer 10

congenital
acquired

Question 11

TRYE OR FALSE: If the cause of valvular heart disease is congenital (birth defect), If there is congenital heart problem there is also congenital problem in the valves.

Answer 11

TRUE

Question 12

What are the acquired causes of valvular heart disease?

Answer 12

• Degenerative — old age (the closing and opening of valves do not function well due to fibrotic
or calcification of the valves)
• Rheumatic (RHD) – can cause calcification
• Infective — streptococcal infection (GABHS, sore throat)

Question 13

What happens it “Aortic Stenosis”?

Answer 13

• Main Problem: Valve NOT Opening Properly
• Left Ventricle squeezes = Valve do not open → increase after load (isu dijay mabati idjay
chamber once nag pump jay ventricle) →LV push harder → Ventricular enlargement

Question 14

What happens in “Mitral Stenosis”?

Answer 14

• Main Problem: Valve NOT Opening Properly
• Left atrium squeezes = Valve do not open → increase afterload → LA push harder → Left atrial
enlargement → left-sided heart failure

Question 15

How does mitral stenosis associated with congestive heart failure?

Answer 15

• if there is mitral stenosis, there is pulmonary signs and symptoms, blood may goes to the lungs
– if lungs is full, it will go back to the right ventricle – once the right ventricle take effort there
is a possibility of right sided hypertrophy — until it develops to right sided heart failure thus
congestive heart failure

Question 16

What happens in “Aortic Regurgitation”?

Answer 16

• Main Problem: Valve NOT Closing Properly
• Left Ventricle squeezes blood through the aorta → valve doesn’t completely close → backflow of blood

Question 17

What happens in “Mitral Regurgitation”?

Answer 17

• Main Problem: Valve NOT Closing Properly
• Left atrium squeezes blood into the LV→ valve doesn’t completely close → backflow of blood

Question 18

Risk Factors of valvular heart disease

Answer 18

hypertension
rheumatic fever
congenital malformations
infective endocarditis
marfan syndrome

Question 19

how does hypertension became a risk factor for valvular heart disease?

Answer 19

due to mechanical stress, over time it could lead to thickening of veins

Question 20

how does rheumatic fever became a risk factor for VHD?

Answer 20

causes inflammation of the heart

Question 21

how does congenital malformation became a risk factor for VHD?

Answer 21

high chance that there is also congenital problem in the valves

Question 22

how does infective endocarditis became a risk factor for VHD?

Answer 22

any type of infection that can get into the heart

Question 23

How does Marfan Syndrome became a risk factor for VHD?

Answer 23

affects connective tissue, weakens the heart’s structure, particularly the valves. This leads to issues like mitral valve prolapse or aortic valve regurgitation, where the valves don’t close properly. Over time, these valve problems can cause valvular heart disease,
increasing the risk of heart complications such as heart failure.

Question 24

Symptoms of VHD

Answer 24

dizziness
fatigue
SOB/dyspnea
Angina (chest pain)

Question 25

How does dizziness became a symptom of VHD?

Answer 25

Valvular dysfunction reduces blood flow and oxygen supply to the brain, causing dizziness.

Question 26

How does fatigue became a symptom of VHD?

Answer 26

Poor valve function leads to inefficient blood circulation, making the body work harder, resulting in
fatigue

Question 27

How does SOB/dyspnea became a symptom of VHD?

Answer 27

When valves fail, blood can back up into the lungs (pulmonary congestion), making it hard to breathe.

Question 28

How does angina(chest pain) became a symptom of VHD?

Answer 28

The heart may struggle to pump blood effectively, leading to reduced oxygen delivery to heart tissues, causing chest pain.

Question 29

What can you assess when patient has VHD?

Answer 29

• Murmur
• ECG
• Palpitations
• Neck, swelling (edema that is causes by fluid shifting)

Question 30

Management of VHD?

Answer 30

Valvular Replacement
Patient Education
valvular replacement, good compliance to medication
Weight the patient everyday

Question 31

What are the different types of Valvular Replacement?

Answer 31

Valvular Replacement (can be detected by 2D Echo)
• Types
o Xenograph – from another species (ex. From animals)
o Allograft – from cadaver/human valve (from other person)
o Autograph – patients own

Question 32

How many years will the valve replacement should be replaced?

Answer 32

7-10 years

Question 33

Medications for VHD

Answer 33

o Anticoagulants – stenosis + regurgitation = stagnant of blood which causes blood clot
o Avoid NSAIDS and Aspirin (ASEA – AcetylSalicylic Acid) – bleeding
o Avoid Gingko Biloba – may interact with heart valve replacement
o Limit caffeine, alcohol → stress heart (palpitations)

Question 34

When patient gains 3 pounds in one day; or 5 pounds in one week, what does this indicate?

Answer 34

fluid overload