Valvular heart disease

Question 1

Valvular heart disease effects the heart as a pump, reducing stroke volume. This can lead to….

Answer 1

• -Hypertrophy (valvular remodeling)

- -HF

Question 2

What are some RF for valvular heart disease?

Answer 2

• -Infective Endocarditis
• -Rheumatic fever, strep
• -Decompensated HF
• -Degeneration
• -Marfan syndrome

Question 3

what is Marfan syndrome?

Answer 3

Connective tissue disorder that affects heart

Question 4

What happens to the leaflets in valvular heart disease?

Answer 4

They become loose and floppy, cannulas become stenotic, then papillary muscle ruptures.

Question 5

Valvular heart disease is often asymptomatic until its late. What are some signs and symptoms of Valvular heart disease?

Answer 5

• -Murmur (turbulent flow)
• -Crackles (both bases)
• -Increased pulmonary artery pressure
• -Hemoptosis
• -Orthopnea
• -Paroxysmal Nocturnal dyspnea
• -nocturia

Question 6

Increased pulmonary artery pressure, orthopnea, and paroxysmal nocturnal dyspnea can indicate what?

Answer 6

Left side valve damage

Question 7

When would hospital staff use a TEE on a patient to diagnose Valvular heart disease?

Answer 7

• -obese pt.
• -COPD
• -Chest wall deformity/trauma (thick dressings)

Question 8

How does the valvular surgery, Ross Procedure help a patient?

Answer 8

It replaces the diseased aortic valve with own pulmonary valve. The pulmonary valve is then replaced with cadaveric valve

Question 9

What are some things the nurse can educate the patient?

Answer 9

• -avoid caffeine/alcohol
• -Report fever, petechaie, rash, SOB immediately
• -Avoid OTC meds with alcohol, ephedrine, or epinephrine (may cause dysrhythmias)

Question 10

When should the patient notify the provider when it comes to weight?

Answer 10

–notify provider of 3lb weight gain in a day or 5 lb in a week

Question 11

Where would the aortic sound be heard when auscultating?

Answer 11

2nd right intercostal space (ICS)

Question 12

Where would the pulmonic sound be heard when auscultating?

Answer 12

2nd left intercostal space

Question 13

Where is ERB’s point located?

Answer 13

3rd left ICS, left sternal border

Question 14

Where is the mitral area/apex located?

Answer 14

5th left ICS, mid-clavicular line (point of maximum impulse)

Question 15

Heart valve murmurs are characterized by….

Answer 15

• -timing (systolic/diastolic)
• -location
• -radiation
• -quality (blowing,grading,harsh)
• -pitch (high/low)
• -loudness(grade 1-4

Question 16

What type of systolic murmur is emergent and why?

Answer 16

Acute mitral regurgitation because papillary muscle ruptures

Question 17

What is the treatment for mitral regurgitation?

Answer 17

IABP and inotropes

Question 18

What type of systolic murmur is a complication of endocarditis?

Answer 18

Tricuspid regurgitation

Question 19

What is a papillary muscle rupture? What signs will we see and what would the nurse watch out for?

Answer 19

• -Medical emergency where the Valve just flops around
• -See sudden issues with perfusion, SOB, anxious, chest pain
• -WATCH OUT FOR NEW MURMURS (need surgery!)

Question 20

What medication will the patient be on for life if they have a mechanical valve surgically inserted?

Answer 20

anticoagulants (prevents clots around valve)

Question 21

What should the tricuspid valve be doing during S1 and S2?

Answer 21

• -S1 = closed

- -S2 = open

Question 22

What should the pulmonic valve be during during S1 and S2?

Answer 22

• -S1 = open

- -S2 = closed

Question 23

What should the mitral valve be doing during S1 and S2?

Answer 23

• -S1 = closed

- -S2 = open

Question 24

What should the Aortic valve be doing during S1 and S2?

Answer 24

• -S1 = open

- -S2 = closed

Question 25

What are the top two causes of valve disorders?

Answer 25

• -rheumatic fever

- -endocarditis

Question 26

What valve disorder is A-fib common?

Answer 26

Mitral stenosis