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    Valvular Heart Diseases

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    Chrystel Mae Pañares
    Valvular heart diseases involve abnormalities of the heart valves such as regurgitation, stenosis, and prolapse. The major valvular diseases are mitral valve prolapse, mitral regurgitation, mitral stenosis, aortic regurgitation, and aortic stenosis. These conditions can cause complications affecting the left atrium, left ventricle, lungs, and right ventricle if not treated. Treatment may involve medical management, valve repair procedures like valvuloplasty and annuloplasty, or valve replacement with prosthetic valves. Nursing care focuses on education, monitoring for symptoms and complications, preventing infectious endocarditis, and care following invasive procedures.

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    Valvular Heart Diseases

    Uploaded by

    Chrystel Mae Pañares
    45 views32 pages
    Valvular heart diseases involve abnormalities of the heart valves such as regurgitation, stenosis, and prolapse. The major valvular diseases are mitral valve prolapse, mitral regurgitation, mitral stenosis, aortic regurgitation, and aortic stenosis. These conditions can cause complications affecting the left atrium, left ventricle, lungs, and right ventricle if not treated. Treatment may involve medical management, valve repair procedures like valvuloplasty and annuloplasty, or valve replacement with prosthetic valves. Nursing care focuses on education, monitoring for symptoms and complications, preventing infectious endocarditis, and care following invasive procedures.

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    Valvular heart diseases involve abnormalities of the heart valves such as regurgitation, stenosis, and prolapse. The major valvular diseases are mitral valve prolapse, mitral regurgitation, mitral stenosis, aortic regurgitation, and aortic stenosis. These conditions can cause complications affecting the left atrium, left ventricle, lungs, and right ventricle if not treated. Treatment may involve medical management, valve repair procedures like valvuloplasty and annuloplasty, or valve replacement with prosthetic valves. Nursing care focuses on education, monitoring for symptoms and complications, preventing infectious endocarditis, and care following invasive procedures.

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    © All Rights Reserved
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    45 views32 pages

    Valvular Heart Diseases

    Uploaded by

    Chrystel Mae Pañares
    Valvular heart diseases involve abnormalities of the heart valves such as regurgitation, stenosis, and prolapse. The major valvular diseases are mitral valve prolapse, mitral regurgitation, mitral stenosis, aortic regurgitation, and aortic stenosis. These conditions can cause complications affecting the left atrium, left ventricle, lungs, and right ventricle if not treated. Treatment may involve medical management, valve repair procedures like valvuloplasty and annuloplasty, or valve replacement with prosthetic valves. Nursing care focuses on education, monitoring for symptoms and complications, preventing infectious endocarditis, and care following invasive procedures.

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    of 32

    VALVULAR HEART

    DISEASES
    REGURGITATION
    Backward flow of blood through a heart
    valve

    STENOSIS
    Narrowing or obstruction of a valve’s
    orifice

    PROLAPSE
    Stretching of an AV valve leaflet into the
    atrium during systole
    A. Mitral Valve Prolapse
    cause: inherited connective tissue
    disorder causing an enlargement of
    the mitral valve leaflet/s
    usually asymptomatic
    mitral click (extra heart
    sound)/murmur: often the first & only
    sign of MVP
    B. Mitral Regurgitation
    Causes: degenerative changes,
    ischemia of the left ventricle, rheumatic
    heart disease, myxomatous changes,
    infective endocarditis, collagen-vascular
    diseases, cardiomyopathy, ischemic
    heart disease
    Left atrium eventually hypertrophies and
    dilates, lungs become congested
    Systolic murmur (high-pitched, blowing
    sound)
    C. Mitral Stenosis
    Cause: rheumatic endocarditis
    Also leads to left atrial hypertrophy,
    pulmonary congestion and right ventricular
    failure
    Symptoms develop with 1/3 to ½ reduction
    of valve opening (1st: dyspnea on exertion)
    Poor ventricular filling ⇢ ⇩ CO
    Low-pitched, rumbling diastolic murmur,
    atrial dysrhythmias
    D. 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 replacement
    Leads to left ventricular failure
    High-pitched, diastolic murmur at 3rd or 4th
    ICS at the left sternal border
    Widened pulse pressure
    Water-hammer (Corrigan’s) pulse
    E. Aortic Stenosis
    Causes: Degenerative calcification,
    congenital leaflet malformations,
    rheumatic endocarditis
    Asymptomatic
    Leads to left ventricular failure
    BP and pulse pressure may be low
    systolic crescendo-decrescendo
    murmur over the aortic area, S4 heart
    sound; vibration felt over base of heart
    MANIFESTATIONS COMPLICATIONS

    MITRAL VALVE •Usually asymptomatic


    PROLAPSE •Mitral click
    MITRAL REGURGITATION Systolic murmur LA dilation and hypertrophy
    (high-pitched) Pulmonary congestion
    Dyspnea RV failure
    Fatigue
    weakness
    MITRAL STENOSIS Dyspnea on exertion – 1st LA dilation and hypertrophy
    symptom Pulmonary congestion
    Weak pulse RV failure
    low-pitched, rumbling
    diastolic murmur
    Atrial dysrhythmias
    MANIFESTATIONS COMPLICATIONS

    AORTIC Diastolic murmur LV dilation and hypertrophy


    REGURGITATION (High-pitched) @ 3rd or 4th LV failure
    ICS, left sternal border
    Widened PP
    Corrigan’s pulse

    AORTIC STENOSIS Asymptomatic LV dilation and hypertrophy


    Low BP & PP LV failure
    Systolic
    cresecendo-decrescendo
    murmur over the aortic
    area
    S4 heart sound
    MEDICAL MANAGEMENT
    • Monitor for dysrhythmias
    • Eliminate caffeine and alcohol
    • Stop smoking
    • Give antidysrhythmics
    • Vasodilators (aortic regurgitation):
    Ca-channel blockers, ACE
    inhibitors, hydralazine
    • Same as with right or left ventricular
    failure
    • Valve repair (valvuloplasty)
    a. Commissurotomy (for mitral
    stenosis)
    b. Annuloplasty – for regurgitation
    c. Chordoplasty – for stretched, torn,
    or shortened chordae tendinae
    • Valve replacement
    Valvuloplasty
    Examples of
    commercially available
    annuloplasty rings.
    From top: St. Judes
    Rigid Saddle Shaped
    Ring, Edwards
    Geoform, Edwards
    Physio, Edwards
    ETlogix, Edwards
    Cosgrove.
    Chordoplasty
    CHORDAL TRANSFER
    VALVE REPLACEMENT
    PROSTHETIC HEART VALVES
    NURSING MANAGEMENT
    • Teach pt about the diagnosis, the progressive nature of the disorder
    and the treatment plan
    • Prophylactic antibiotic therapy before undergoing invasive
    procedures
    • Minimize risk for infectious endocarditis:
    • Good oral hygiene
    • Routine dental care
    • Avoid body piercing
    • Don’t use toothpicks/sharp objects into oral cavity
    • First-degree relatives may be advised to have echocardiograms
    • Mitral stenosis: anticoagulants
    • Avoid strenuous activities, competitive sports, and isometric exercise
    ISOMETRIC
    EXERCISES
    • monitor v/s, heart and lung sounds
    • palpate peripheral pulses
    • assess for s/s of heart failure, dysrhythmias,
    angina
    • take wt daily, report gains of 2 lbs in a day or
    5 lbs in 1 week
    • valvuloplasty and replacement:
    • assess for s/s of emboli & heart failure
    • same care for post-procedure cardiac
    catheterization or PTCA
    • medications for BP regulation,
    dysrhythmias
    • pt teaching on diet, activity,
    medications, and self-care
    • educate about long-term
    anticoagulant therapy –
    warfarin or aspirin
    • doppler echocardiograms
    performed 3-4 wks from
    discharge
    THE END!

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