VALVULAR HEART DISEASES Transes Prelims

VALVULAR HEART DISEASES
Regurgitation endocarditis, collagen-vascular diseases,

➢ Backward flow of blood through a heart cardiomyopathy, ischemic heart disease
valve ➢ Left atrium eventually hypertrophies and
Stenosis dilates, lungs become congested
➢ Narrowing or obstruction of a valve’s ➢ Systolic murmur (high-pitched, blowing
orifice sound)
Prolapse
➢ Stretching of an AV valve leaflet into the
atrium during systole
Mitral Valve Prolapse
➢ A portion of one or both mitral valve
leaflets balloons back into the atrium
during systole
Mitral Regurgitation
➢ Blood flows back from the left ventricle into
the left atrium during systole
Mitral Stenosis
➢ Obstruction of blood flowing from the left
atrium into the left ventricle
Aortic Regurgitation MITRAL STENOSIS
➢ The flow of blood back into the left ventricle ➢ Causes: rheumatic endocarditis
Aortic Stenosis ➢ Also leads to left atrial hypertrophy,
➢ Narrowing the orifice between the left pulmonary congestion and right ventricular
ventricle and the aorta failure
➢ Symptoms develop with 1/3 to ½ reduction
MITRAL VALVE PROLAPSE of valve opening (1st: dyspnea on
➢ Cause: inherited connective tissue exertion)
disorder causing an enlargement of the ➢ Poor ventricular filling ⇢ ⇩ CO
mitral valve leaflet/s ➢ Low-pitched, rumbling diastolic murmur,
➢ Usually, asymptomatic atrial dysrhythmias
➢ Mitral click (extra heart sound)/murmur:
often the first and only sign of MVP
AORTIC REGURGITATION
➢ Inflammatory lesions that deform the
leaflets of the aortic valve; infective or
rheumatic endocarditis, congenital
abnormalities, aneurysm, blunt chest
trauma, deterioration of an aortic valve
MITRAL REGURGITATION replacement
➢ Causes: degenerative changes, ischemia ➢ Leads to left ventricular failure
of the left ventricle, rheumatic heart ➢ High-pitched, diastolic murmur at 3rd or
diseases, myxomatous changes, infective 4th ICS at the left sternal border
AGBON 3E
➢ Widened pulse pressure Complications
➢ Water-hammer (Corrigan’s) pulse • LA dilation and hypertrophy
• Pulmonary congestion
• RV failure
MITRAL STENOSIS
Manifestations
• Dyspnea on exertion – 1st symptom
• Weak pulse
• Low-pitched, rumbling diastolic murmur
• Atrial dysrhythmias
Complications
• LA dilation and hypertrophy
• Pulmonary congestion
AORTIC STENOSIS
• RV failure
➢ Causes: Degenerative calcification,
AORTIC REGURGITATION
congenital leaflet malformations,
Manifestations
rheumatic endocarditis
➢ Asymptomatic • Diastolic murmur (high-pitched) @ 3rd or
➢ Leads to left ventricular failure 4th ICS, left sternal border
➢ BP and pulse pressure may be low • Widened PP
➢ systolic crescendo-decrescendo murmur • Corrigan’s pulse
over the aortic area, S4 heart sound; Complications
vibration felt over base of heart • LV dilation and hypertrophy
• LV failure
AORTIC STENOSIS
Manifestations
• Asymptomatic
• Low BP & PP
• Systolic crescendo-decrescendo murmur
over the aortic area
• S4 heart sound
Complications
• LV dilation and hypertrophy
• LV failure
MEDICAL MANAGEMENT
MANIFESTATIONS & COMPLICATIONS ✓ Monitor for dysrhythmias
Mitral Valve Prolapse ✓ Stop smoking
Manifestations ✓ Eliminate caffeine and alcohol
• usually asymptomatic ✓ Give antidysrhythmics
• mitral click ✓ Vasodilators (aortic regurgitation): Ca-
Complications channel blockers, ACE inhibitors,
• hydralazine
Mitral Regurgitation
Manifestations
• Systolic murmur (high-pitched)
• Dyspnea
• Fatigue
• Weakness
AGBON 3E
NURSING MANAGEMENT
✓ Teach the px about the diagnosis, the
progressive nature of the d/o, and the
treatment plan
✓ Prophylactic antibiotic therapy before
undergoing invasive procedures
✓ First-degree relatives may be advised to
have echocardiograms
✓ Mitral Stenosis: anticoagulants
✓ Minimize risk for infectious
endocarditis: good oral hygiene, routine
dental care, avoid body piercing, don’t use
toothpicks/sharp objects into oral cavity
✓ Avoid strenuous activities, competitive
sports, and isometric exercises
✓ Monitor v/s, heart and lung sounds
✓ Palpate peripheral pulses
✓ Assess for s/s of heart failure,
dysrhythmias, angina
✓ Take weight daily, report gains of 2lbs in a
day or 5lbs in 1 week
✓ Valvuloplasty and replacement: assess
for s/s of emboli, same care for post-
procedure cardiac catheterization or
PTCA, medications for BP regulation,
dysrhythmias
✓ Patient teaching on diet, activity,
medications, and self-care
✓ Educate about long-term anticoagulant
therapy – warfarin or aspirin
✓ Doppler echocardiograms performed 3-
4wks from discharge
AGBON 3E

VALVULAR HEART DISEASES Transes Prelims

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VALVULAR HEART DISEASES

Regurgitation endocarditis, collagen-vascular diseases,

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