Valvular Heart Disease - Nursing |, Study notes of Nursing

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VALVULAR HEART DISEASE

Cardiac Valves

Unidirectional flow of blood through the heart stenosis narrowing of the valve lumen-impedes flow  insufficiency regurgitation, backward flow of blood compensation: dilation/hypertrophy

Mitral Stenosis

More common in women impedes blood flow from LA to LV cause: rheumatic fever, carditis, bacterial vegitation, thrombus formation, calcification, tumor Leaflets become thick/fibrotic/scar tissue/calcifications LA dilation Pulmonary congestion risk of dysrythmias, thrombus formation

Mitral Stenosis Management

Diagnosed by ascultation ECG CXR Echo Heart Cath Medication diuretics Digoxin O anticoagulants prophylactic antibiotics Procedures percutaneous valvuloplasty Balloon dilation

Surgical Procedures

Commissurotomy (Iggy pg.766 ) open closed Valve Replacement

Mitral

Regurgitation/Insufficiency

Fails to close completely backward flow from LV to LA during systole often seen in middle age to elderly men

Etiology

Rheumatic heart disease, endocarditis, CAD, Cardiomyopathy, various mitral valve disorders weakness/rupture/ fibrosis of papillary muscle Rupture of chordae tendineae or perforation of valve cusp Connective tissue disorders Amyloidosis, ankylosing spondylitis

Diagnosis

Ascultation CXR ECG Echo Heart Cath

Medications/Treatment

Diuretics Digoxin antiarrythmics Cardioversion if A.fib  Anticoagulants  Surgical Repair

Pathyphysiol

ogy

Leaflets become thickened/enla rged elongated chordae tendineae leaflets billow up into LA often see regurgitation

Symptoms

Often asymptomatic palpitations dysrythmias, tachycardia lightheadness, syncope, fatigue dyspnea chest tightness hyperventilation Anxiety, depression panic attacks atypical CP may have altered catecholamine release LV failure embolus, CVA midsystolic click, late systolic murmur with regurgitation

Treatments

Medications B-Blockers with symptoms anticoagulants PRN Echo every few years surgery if severe Patient/Family Education Avoid Caffeine medication activity as tolerated

Aortic Stenosis

Aortic Leaflets become stiff/fused/calcified impedes blood flow from LV to aorta during ventricular systole Etiology: congenital, endocarditis, calcification