Valvular Disorders

Regurgitation valves do not

close/open properly and theres a
backflow
Stenosis valve does not open
completely and flow of blood is
reduced
Prolapse - a slippage or sinking of a
valve of the heart from its usual
position

Mitral Valve Prolapse

Produces no symptoms; occurs

more frequently in women; usually
inherited connective tissue disorder
resulting in enlargement of one or
both of mitral valve leaflets
Fatigue,
SOB,
lightheadedness,
dizziness, syncope, palpitations,
chest pain, anxiety
Extra heart sound, mitral click
Prophylactic meds (antibiotics),
mitral valve repair
Patient teaching

Mitral Regurgitation

Involves blood flowing back from

the left ventricle into the left
atrium during systole
Dyspnea,
fatigue,
weakness,
palpitations, SOB, cough
Prophylactic meds (antibiotics),
restrict
activity
level,
mitral
valvuloplasty/valve replacement

Mitral Stenosis

Obstruction of blood flowing from

the left atrium into the left
ventricle
Often
caused
by
rheumatic
endocarditis

Dyspnea, progressive fatigue, low

cardiac
output,
enlarged
left
atrium, dry cough, wheezing,
palpitations,
orthopnea,
PND,
repeated respi infections
Anticoagulants to dec rick for
developing atrial thrombus, Tx for
anemia, avoid strenuous activities,
valvuloplasty,
mitral
valve
replacement

Aortic Regurgitation

Flow of blood back into left

ventricle from aorta during diastole
May be caused by inflammatory
lesions,
infective/rheumatic
endocarditis,
congenital
abnormalities, syphilis, blunt chest
trauma
Forceful
heartbeat,
orthopnea,
PND, dyspnea, fatigue
Avoid physical exertion, Tx for
dysrhymias and HF, vasodilators,
CCB, ACE inhibitors, hydralazine
Aortic
valvuloplasty/valve
replacement

Aortic Stenosis

Narrowing of the orifice bet the LV

and
the
aorta;
result
of
degenerative calcifications
Asymptomatic; exertional dyspnea,
orthopnea,
PND,
pulmonary
edema, dizziness, syncope, angina
pectoris
Meds to treat dysrhythmia of LV
failure

VALVULOPLASTY
COMMISSUROTOMY
fused leaflets

separate

ANNULOPLASTY repair of valve

annulus

LEAFLET REPAIR
CHORDOPLASTY
tendinae

repair chordae

VALVE REPLACEMENT

Occurs most often in school-age

children
May develop after an episode of
group
A
beta-hemolytic
streptococcal pharyngitis
Prompt Tx of strep throat with
antibiotics
can
prevent
the
development of rheumatic fever

Infective Endocarditis

Cardiomyopathy

Heart muscle dse accoc with

cardiac dysfxn
Dilated: most common form;
dilation of the ventricles without
simultaneous
hypertrophy;
pregnancy,
heavy
alcohol
intake,
viral
infection,
chemotherapeutic
meds,
Chagas dse.
Hypertrophic: rare autosomal
dominant condition; occurring in
all age groups, often detected in
puberty
Restrictive: right ventricular
walls that impair diastolic filling
and ventricular stretch
HF s/sx, PND, cough, orthopnea,
peripheral edema, fluid retention,
dizziness,
palpitations,
nausea,
syncope, chest pain
Correcting
HF,
low-Na
diet,
exercise/rest regimen, controlling
dysrhythmias, fluid intake may be
limited to 2L each day, limit
physical activity, heart transplant

Rheumatic Endocarditis

Microbial
infection
of
the
endothelial surface of the heart
Develops in people with prosthetic
heart valves

Myocarditis

Inflammatory process involving the

myocardium
Heart dilation, thrombi on the heart
wall (mural thrombi), infiltration of
circulating blood cells around the
coronary vessels and bet the
muscle fibers and degeneration of
the muscle fibers themselves
Prevention!
Appropriate
immunizations
Tx of underlying cause if known,
physical activity is inc slowly, BR,
dec cardiac workload
Monitor patient, for tachycardia,
fever,
cardiac
activity,
antiembolism stockings, active and
passive ROM exercises

Pericarditis

Inflammation of the pericardium;

primary illness or may develop into
a disorder
Asymptomatic; chest pain (may be
located beneath the clavicle, neck ,
scapula regions), creaky, scratchy
friction rub at left lower sternal
border
NSAIDS, analgesics, Tx of cause
Health teachings!

Cellulitis

Most common infectious cause of

limb swelling
Can occur as a single isolated
event or a series or recurrent
events
Swelling, fever, chills, sweating,
redness, tender and enlarged
lymph nodes
Antibiotic therapy
Elevate affected area above heart
level and apply warm, moist packs
to the site every 2-4 hrs