Valvular heart disease.pdf

valvular heart disease for B.Sc. nursing course

1. VALVULAR HEART DISEASE
BY
MR.RAVISHANKAR
NURSING TUTOR
OJASWINI NURSING COLLEGE, SAGAR

2. INTRODUCTION:-
Inheartvalvedisease,oneormoreofthevalvesinyourheartdoesn't
workproperly.Yourhearthasfourvalvesthatkeepbloodflowinginthe
correctdirection.Insomecases,oneormoreofthevalvesdon'topenor
closeproperly.Thiscancausethebloodflowthroughyourhearttoyour
bodytobedisrupted.

3. DEFINITION:-
Anacquiredorcongenitaldisorderofcardiacvalve
characterizedbystenosis(obstruction)orbackwardflow
ofblood.

4. •Defined according to the valve or valves affected and type of functional
alteration.
Includes
Stenosis (obstruction)
Regurgitation (backward flow of blood)

5. TYPES OF VALVE DISEASE
•Stenosis-valvedoesn'topenalltheway,notenoughbloodpasses
through.
•Regurgitation-valvedoesn'tcloseallthewaysobloodleaks
backwards.

6. Stenosis-valveorificeissmaller,impendingtheforwardflow
ofbloodandcreatingapressuregradientdifferenceacrossan
openvalve.
Regurgitation-incompleteclosureofvalveleafletsresultsin
thebackwardflowofblood.

7. MITRAL STENOSIS:-
Mostcommonvalvulardisorderinrheumaticfever.
Mayalsobecausedbybacterial,infection,thrombus
formation.
Obstructbloodflowfromleftatriumtotheleftventricle.

8. PATHOPHYSIOLOGY
Narrowing of mitral valve
Increase Left atrial pressure
Decrease blood flow to left ventricle
Increase Pulmonary pressure
Pulmonary congestion
Decrease O2 (fatigue)
Right side failure

9. CLINICAL MANIFESTATION: -
Exertional dyspnea (not being able to breathe fast or deeply enough during
physical activity)
Fatigue
Loud first heart sound
Low pitch diastolic murmur
Hoarseness of voice
Chest pain
Seizures or a stroke

10. MITRAL REGURGITATION: -
Incompleteclosureofthemitralvalve.
Rheumaticdiseaseisthepredominantcause.
Mayalsobeduetocongenitalanomaly,infective
endocarditis.

11. ETIOLOGY:-
Myocardial infarction.
Chronic rheumatic heart disease.
Mitral valve prolapse.
Infective endocarditis.

12. CLINICAL MANIFESTATION: -
Fatigue
Weakness
Dyspnea & cough
Palpitation due to atrial fibrillation
Right side heart failure
Distended Neck veins, edema
High pitched systolic murmur

13. MITRAL VALVE PROLAPSE

14. CAUSES:-
•Inherited connective tissue disorder–enlargement of one or both valve
leaflets.

15. CLINICAL MANIFESTATION: -
Palpitations
chest pain
Dyspnea (shortness of breath)
Do not respond to antianginal treatment.

16. AORTIC STENOSIS
Aorticstenosis—isatypeofheartvalvedisease(valvular
heartdisease).Thevalvebetweenthelowerleftheartchamber
andthebody'smainartery(aorta)isnarrowedanddoesn'topen
fully.Thisreducesorblocksbloodflowfromthehearttothe
aortaandtotherestofthebody.

17. ETIOLOGY

18. PATHOPHYSIOLOGY: -
Due to etiological factor
Narrowing of artic valve
Incomplete emptying of left atrium
Pulmonary congestion
Decrease O2 supply
Myocardial ischemia (chest pain)
Aortic stenosis

19. CLINICAL MANIFESTATION: -
Fatigue
Chest pain
Vertigo
Weakness
Pulmonary edema
Pulmonary congestion
Harsh auscultation

20. AORTIC REGURGITATION: -

21. CAUSES:-
Rheumatic fever is most common cause.
Severe hypertension
Congenital anomaly.
Connective tissue disease.

22. CLINICAL MANIFESTATION: -
Tachycardia(rapid heart rate)
Dyspnea (shortness of breath)
Chest pain-myocardial ischemia
Left heart failure
Fatigue
Peripheral edema

23. DIAGNOSTIC EVALUATION
History and physical examination
Echocardiogram
Cardiac catheterization
Electrocardiogram
Chest x-ray

24. MANAGEMENT: -
Antibiotic therapy (rheumatic fever, infective endocarditis)
Vasodilators
Beta blockers
Diuretics
Low sodium diet should be prescribed
Anticoagulant therapy to treat pulmonary embolization

25. SURGICAL MANAGEMENT: -
Valvuloplasty-is repair of cardiac valve. Patient does not
require continuous anti-coagulant medication.Usually require
cardiopulmonary bypass machine.

26. ANNULOPLASTY -
Itisrepairofvalveannulus(junctionofthevalveleafletand
themuscularheartwall).Narrowsthediameterofthevalve's
orifice,usefulforvalvularregurgitation.

27. CHORDOPLASTY-
Isrepairofchordaetendineae.Doneformitralvalve
regurgitation-causedbystretchedorshortenedchordae
tendineae.

28. NURSING MANAGEMENT: -
•Assess the high risk patient.
•Monitor ECG
•Assess the family history of heart disease.
•Assess the history of smoking and alcoholism.
•Monitor vital sign.
•Instruct to avoid high fat and oil rich diet.