Valve Disorders

Question 1

Rheumatic fever

Answer 1

Acute multi system inflammation

Question 2

Cause of RF

Answer 2

Untreated Streptococcus pharyngitis - didn’t finish antibiotic or misdiagnosed

Question 3

40% of RF can cause?

Answer 3

Pancarditis (all 3 layers of the heart)

Question 4

RF inflammation can cause?

Answer 4

Fibrous, scar tissue in myocardium

Question 5

Rheumatic endocaditis

Answer 5

Valves are affected

Question 6

Modified Jones Criteria?

Answer 6

Diagnosis for Rheumatic fever

Question 7

Which valve is most affected by Chronic Rheumatic carditis?

Answer 7

Mitral but aortic and tricuspid can be affected

Question 8

Txn for RH?

Answer 8

Penicillin (treat infection) and NSAIDS, Colchicine

Question 9

Nursing interventions

Answer 9

1. Health promotion and disease prevention
2. Seek medical attention if you have strep throat
3. Education on meds and finishing the meds
4. Rest and relieve pain
5. Admin penicillin

Question 10

Type of Valve Diseases

Answer 10

Stenosis and Regurgitation

Question 11

Stenosis

Answer 11

Narrowing - impairing forward blood flow

Question 12

Regurgitation

Answer 12

Incomplete closure - back flow of blood

Question 13

Causes of valvular heart disease?

Answer 13

RH
AIDS
Congenital conditions (born)
Older Adults w/ cardiovascular diseases
Infective endocarditis

Question 14

Mitral valve stenosis most commonly from?

Answer 14

RHD (mostly)
Congential
RA
SLE (lupus)

Question 15

What happens in mitral valve stenosis?

Answer 15

LA pressure increases due to increased volume (pressure overload)
Pulmonary vascular resistance increases because of hypertrophy in vessel

Question 16

S/S of mitral stenosis

Answer 16

DOE, fatigue, Afib, low pitched diastolic murmur at Apex

Question 17

Mitral regurgitation causes

Answer 17

MI (mostly), RHD, MVP, IE, ischemic papillary muscle dysfunction

Question 18

S/S in Acute MR

Answer 18

Pulmonary edema and cardiogenic shock

Question 19

S/S of chronic MR

Answer 19

LV failure, S3, Murmur - surgery needed to prevent LV failure or Pulmonary hypertrophy

Question 20

Acute MR intervention

Answer 20

Needs quick intervention to cath lab or surgery for valve repair or replacement

Question 21

Mitral prolapse can cause

Answer 21

Mitral regurgitation, HF, infectious endocarditis

Question 22

S/S of mitral prolapse

Answer 22

Most are asymptomatic, 10% shows signs of
Palpitations
Dyspnea
Chest pain
Activity intolerance
Syncope
Murmur
Mid-systolic click

Question 23

Management of mitral prolapse

Answer 23

1. Beta blocker
2. Stay well hydrated
3. Exercise
4. Avoid caffeine and stimulants
5. Antibiotics prophylaxis

Question 24

Aortic stenosis usually seen from?

Answer 24

1. Congenital
2. RF if from this leaflets stiffen and retract, resulting in stenosis
3. Adult or 65 or older

Question 25

Pathology of Aortic Valve

Answer 25

Blood flow is obstructed from LV to aorta during systole. LV hypertrophy occurs so O2 demand increases Disease progression results in- decreased CO, tissue perfusion, pulmonary hypertrophy and HF

Question 26

S/S of Aortic valve stenosis

Answer 26

Angina, syncope, exertional dyspnea (LV HF), HF, systolic murmur, diminished or absent S2 and prominent S4

Question 27

Aortic Valve regurgitation?

Answer 27

Blood flow from the aorta into the LV during diastole - which will cause hypertrophy due to overload

Question 28

Acute Aortic valve regurgitation can cause?

Answer 28

Cardiovascular collapse Profound dyspnea Chest pain Hypotension Cardiogenic shock This is a MEDICAL EMERGENCY

Question 29

Chronic Aortic Valve Regurgitation can?

Answer 29

Remain asymptomatic for years. Heart sounds- soft S1, S3 or S4, soft, high pitched diastolic murmur. Low pitched murmur in severe.

Question 30

In Tricuspid and Pulmonary Valve diseases?

Answer 30

Stenosis is most common

Question 31

Tricuspid stenosis we see?

Answer 31

RA enlargement elevated systemic venous pressure

Question 32

Tricuspid stenosis seen from?

Answer 32

IV drug users and RH

Question 33

Pulmonic stenosis is seen from?

Answer 33

Congenital

Question 34

Pulmonic stenosis results in?

Answer 34

RV hypertrophy and HTN

Question 35

How to diagnosis Valve Heart Disease?

Answer 35

1. History and Physical - Did they have Rheumatic fever as a child? Have you had a sore throat? 2. Heart sounds, CXR, EKG 3. Most definite is Echo 4. Heart cath

Question 36

Treatment for Valves?

Answer 36

1. Depends on severity 2. Treat symptoms and prevent exacerbations 3. Meds like vasodilators, inotropes, BB, diuretics, low Na 4. Surgery- valvuotomy is procedure of choice - to repair closed or open. Closed - transventricular dilator is inserted Open- cardiac bypass 5. Valve replacement with prosthetic