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25 Cards in this Set

  • Front
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Valvular Stenosis
opening narrowed or malformed
-heart unable to pump blood to body
-more force required (increased)
Vavular regurgitation
do not close completely
-blood flows backward
-BAK FLOW
Acquired valve disease
-MI: damage
-Acute Rheumatic fever
-infectious endocarditis
-connective tissue abnormalities
-congenital
Mitral valve stenosis
-Rheunatic fever- most common: thickense by fibrosis and calcifications

-also from thrombus formation, ca++ accum

-L. atrial pressure rises and dilates
-pulmonary artery pressures increase (flow backs-up) = pulmonary HTN and congestion =DOE, orthopnea, activity intolerance

-left ventricle not getting enough blood vol = dec CO and preload

-monitor for A.fib! very common; must report
Mitral regurg
-incomplete closure of valve during SYSTOLE

-backflow to the LA
-insidious- remain symptom free for decades

-symptomatic d/t DEC. CO
LV fails to respond to inc blood volumes > fatigue, syncope, chest discomfort, anxiety, dyspnea

-inc volume and pressure to be ejected > hypertrophy of both chambers

-rheumatic heart disease is a common cause with some current mitral stenosis present

-affects women more
-nonrheumatic causes: papillary mus dysfunction or rupture from ishemic heart disease, infective endocarditis, and congenital
What is Rheumatic fever?
-untreated strept infection > Ab released to fight it but also attacks tissues of joints and heart > scars heart valves esp mitral stenosis
Aortic stenosis
-increases afterload (resistance) = ventricular hypertrophy

-LV fails > vol. backs up in LA > pulmonary congestion > RHF occurs late in disease

-*when the surface area of the valve becomes < 1 cm, surgery is indicated with urgency!

-symp: dyspnea, angina, and syncope on exertion
late: fatigue, delilitation, peripheral cyanosis

-assessment: narrow pulse pressure when BP is examined

-congenital
aortic regurgitation
incomplete closure during DIASTOLE

-back flow to the LV during diastole = hypertrophy

-similar symptoms as others; no symp for many years
-decreased CO
-nonrheumatic causes
mitral stenosis imaging findings
chest xray
-left atrial enlargemtne,
-prominent pulmonary arteries,
-enlarged right ventricle
mitral regurg imaging findings
chest xray
increased cardiac shadow
LV and LA enlargement
aortic stenosis imaging
later:
LV enlargement
pulmonary congestion
aortic regurg imaging
-LA & LV dilation
tricuspid stenosis or regurg
-Right side of the heart

-Rheumatic fever

-decreased CO, increased CVP

-backward flow into systemic circulation > edema, neck distension, enlarged liver (RHF s/s)
pulmonic stenosis or regurg
-uncommon
-congenital
Assessment of valvular disease
Question client about attacks of rheumatic fever, infective endocarditis, and possibility of IV drug abuse.

Obtain chest x-ray, echocardiogram (preferrable), and exercise tolerance test.
Restrictive cardiomyopathy
Infiltrative process
Fibrosis & thickening
Inpaired diastolic stretch
Ventricular stretch

-rarest
-restriction of filling of the venticles

-emboli common!! emergency of actue pulmonary edema

-walls cannot expand or contract
-treat HTN
hypertrophic cardiomypathy
Treatment- contraindicaed with vasodialators (obstructive form)
-sudden death common with atlethes
-single-gene autosomal dominant trait
-asymmetric vent hypertophy and disarray of myocaridal fibers

-conversion of A.fib
dilated cardiomyopathy
-interference of myocardial metabolism
-thrombi
-left vent failure
-tx vasodilators
Infective Endocarditis
Microbial infection involving the endocardium

Occurs primarily with IV drug abuse, valvular replacements, systemic infections, or structural cardiac defects

Possible ports of entry: mouth, skin rash, lesion, abscess, infections, surgery, or invasive procedures including IV line placement
Interventions for Infective Endocarditis
Antimicrobials

Rest, balanced with activity

Supportive therapy for heart failure

Anticoagulants

Surgical management

Valve removed
key features of endocarditis
fevere wtih chills, night sweats, fatigue
anorexia and wt loss
cardiac murmur
HF
emboli
Stable Angina Pectoris
Temporary imbalance between the coronary artery’s ability to supply oxygen and the cardiac muscle’s demand for oxygen
zone of ischemia
T wave inversion
zone of injury
st elevation
zone of necrosis
abnormal Q