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69 Cards in this Set
- Front
- Back
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Causes of mitral valve prolapse |
Most causes unknown what may be inherited so first-degree relatives need Echo |
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Manifestations of mitral valve prolapse |
Most are asymptomatic, others experience fatigue, shortness of breath, dizziness, syncope, palpitations, chest pain not correlated with activity, anxiety. Mitral click, murmur(louder=more.symptomatic) |
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Management for mitral valve prolapse |
Control symptoms, eliminate caffeine and alcohol stop smoking, anti-arrhythmic medications |
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Portion of one or both mitral valve leaflets balloons back into the atrium during systole. |
Mitral valve prolapse |
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Blood flowing back from left ventricle to left atrium during systole |
Mitral regurgitation |
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Most common cause of mitral regurgitation |
Degenerative changes of the mitral valve, ischemia of the left ventricle |
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Manifestations of mitral regurgitation |
Most asymptomatic but with acute mitral regurgitation May have dyspnea fatigue weakness palpitations cough and systolic murmur: high pitched blowing sound at Apex. Diagnosed with Echo |
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Management for mitral regurgitation |
Same as heart failure( ACE inhibitors, arbs, beta blockers), restrict activity level to minimize symptoms |
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An obstruction to blood flowing from the left atrium to the left ventricle most often caused by Rheumatic endocarditis |
Mitral stenosis |
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Clinical manifestations for mitral stenosis |
Dyspnea on exertion, fatigue, cough, palpitations, paroxysmal nocturnal dyspnea so, we can regular pulse. Diagnosed with Echo |
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Prevention for mitral stenosis |
Minimizing risk of and treatment for bacterial infections |
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Management for mitral stenosis |
Same as congestive heart failure, May benefit from anticoagulants, valve repair or replacement, avoid strenuous activities competitive Sports and pregnancy because they increase heart rate |
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Flow of blood back into the left ventricle from the aorta during diastole. May be caused by inflammatory lesions that deform aortic valve leaflets or dilation of the aorta preventing complete closure of the aortic valve |
Aortic regurgitation |
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Manifestations of aortic regurgitation |
Most asymptomatic. Some are aware of forceful heartbeat, marked arterial pulsations visible are probably at carotid or temporal arteries, dyspnea on exertion, fatigue, diastolic murmur, widened pulse pressure |
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Management for aortic regurgitation |
Avoid physical exertion, competitive Sports and isometric exercise, treat heart failure and dysrhythmias Trauma calcium channel blockers and ACE inhibitors valve repair or replacement |
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Narrowing of the orifice between the left ventricle and aorta. Often a result from degenerative changes and calcifications |
Aortic stenosis |
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Manifestations of aortic stenosis |
Many patients are asymptomatic. Some symptoms that may develop or dystonia on exertion, increased pulmonary venous pressure, orthopnea, paroxysmal nocturnal dyspnea, pulmonary edema dizziness, syncope, chest pain, systolic murmur, S4 heart sound. Diagnosed with Echo and CT |
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Prevention of aortic stenosis |
Control risk factors for proliferative and inflammatory responses through treating diabetes hypertension cholesterol and triglycerides and avoiding tobacco products |
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Management for aortic stenosis |
Medications to treat dysrhythmias or left ventricular failure. Definitive treatment is surgical replacement of the aortic valve. |
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Repair of a cardiac valve |
Valvuloplasty |
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Anticoagulation with valvuloplasty |
Anticoagulation for 3 months |
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Most common valvuloplasty procedure, separate fuse leaflets. Can we closed performed in the cath lab or open in open heart surgery |
Commissurotomy |
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Repair of valve annulus. Open heart procedure. Under general anesthesia and cardiopulmonary bypass. |
Annuloplasty |
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Repair of elongated ballooning or excess tissue leaflets. Open procedure |
Leaflet repair. |
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Repair of chordae tendineae. |
Chordoplasty |
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More durable valves often used for younger patients or for patients with renal failure hypercalcemia endocarditis or sepsis. Require long-term anticoagulation |
Mechanical valves |
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Valves less likely to generate thromboemboli. No long-term anticoagulant required |
Tissue valves |
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Tissue valves used for aortic mitral and tricuspid valve replacement. From pigs cows or horses. 7 to 15 year viability. |
Bioprosthesis or heterograft tissue valve |
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Valves used for aortic and pulmonic valve replacement from donation. Very expensive. Last 10 to 15 years |
Homograft or allograft tissue valve |
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Valve obtained by excising the patient's own pulmonic valve in a portion of the pulmonary artery for used as they ordered valve. Viable for more than 20 years. |
Autograft tissue valve |
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Teaching after valve repair or replacement |
Anticoagulation therapy. With mechanical valve it is long-term. With tissue valve only for 3 months. Educate about all prescribed medications and how to minimize the risk of developing infective endocarditis |
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Preventing infection after valve replacement repair |
Prophylactic antibiotics before dental work and invasive procedures. Echocardiograms performed three to four weeks after Hospital discharge then usually repeated every 1 to 2 years |
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Disease of the heart muscle that is associated with cardiac dysfunction |
Cardiomyopathy |
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Most common form of cardiomyopathy. Distinguish by significant dilation of ventricles without simultaneous hypertrophy |
Dilated cardiomyopathy |
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Causes of dilated cardiomyopathy |
Pregnancy, healthy alcohol intake, viral infection, chemotherapeutics medications and idiopathic. An echo needs to be done and all first-degree blood relatives because there may be genetic factors |
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Cardiomyopathy characterized by diastolic dysfunction caused by Ridgid ventricular walls that impaired diastolic filling and ventricular stretch |
Restrictive cardiomyopathy |
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Rare cardiomyopathy where heart muscle asymmetrically increases especially along the septum |
Hypertrophic cardiomyopathy |
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Clinical manifestations of cardiomyopathy |
Asymptomatic. Present with signs of heart failure such as dyspnea on exertion, fatigue. Patients also report cough, orthopnea, peripheral edema, nausea, chest pain, dizziness, syncope, pnd |
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Medical management for cardiomyopathies |
Directed toward identifying and managing possible underlying or precipitating cause |
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Management to correct heart failure with cardiomyopathy |
Medications, low sodium diet, exercise and rest, fluid restrictions |
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Low sodium diet |
Avoid process canned foods, TV dinners, lunch meat or hot dogs, pretzels, peanuts and table salt |
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Management to control dysrhythmias with cardiomyopathy |
Anti-arrhythmic medications, implantable cardioverter-defibrillator, anticoagulation, pacemaker |
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Surgical management for cardiomyopathy |
Myectomy which is removing some of the muscle or left ventricular outflow tract which helps move the blood along |
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Steps to prevent rejection of heart transplant |
Lifelong immunosuppressants |
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Complications of ventricular assistive devices and total official hearts |
Bleeding disorders, Hemorrhage, thromboemboli, hemolysis, infection, renal failure, right sided heart failure, multi-system failure and mechanical failure |
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Nursing interventions for patient with cardiomyopathy |
Improve cardiac output and peripheral blood flow by rest, 02, meds, low sodium diet and daily weight. Approve gas exchange by alternating rest periods and activity. Reduce anxiety, decrease sense of powerlessness |
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Education with cardiomyopathy |
Educate up medications, symptom monitoring and symptom management |
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Caused by acute rheumatic fever that may develop after an episode of group a beta hemolytic streptococcus pharyngitis |
Rheumatic endocarditis |
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Signs and symptoms of streptococcal pharyngitis that could lead to Rheumatic endocarditis |
Fever of 101 to 104, chills, sudden onset of sore throat, diffuse redness of throat with exudate on oropharynx, enlarged and tender lymph nodes, abdominal pain, acute sinusitis and acute otitis media |
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Heart changes from Rheumatic endocarditis |
Murmur, thrill, dysrhythmias, heart failure, pericarditis, clots |
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Microbial infection of the endothelial surface of the heart. Usually develops in people with prosthetic heart valves, cardiac devices or structural cardiac defects |
Infective endocarditis |
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Risk factors for infective endocarditis |
Prosthetic cardiac valves, implanted cardiac devices, history of bacterial endocarditis, congenital heart disease, cardiac transplant recipients with valvulopathy, IV drug abuse, body piercing and tattooing |
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Clinical manifestations of infective endocarditis |
Fever, heart murmur, clusters of petition, Osler nodes(pads of fingers and toes) , Janeway lesions(red/ purple flat macules on palms, fingers, toes, hands, soles), Roth spots(eyes), splinter hemorrhages, headache |
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Prevention for infective endocarditis |
Prophylactic antibiotics before invasive procedures, good oral hygiene, avoid body piercings and tattooing, avoid nail-biting, avoid using toothpicks are other sharp objects in the oral cavity, minimize outbreaks of acne, hand hygiene |
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Management for infective endocarditis |
IV antibiotic therapy for 2 to 6 weeks, Home Care, surgical debridement, and her temperature to evaluate effectiveness of treatment, monitor heart sounds for a new or worsening murmur, assess invasive lines |
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An inflammatory process involving The myocardium, can cause heart dilation, thrombi on the heart wall, infiltration of circulating blood cells around the coronary vessels in between the muscle fibers, degeneration of muscle fibers themselves |
Myocarditis |
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Causes of myocarditis |
Viral bacterial fungal and parasitic infections |
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Manifestations of myocarditis |
Fatigue, dyspnea, syncope, palpitations, occasional discomfort in the chest and upper abdomen. Most common symptoms are flu-like |
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Prevention of myocarditis |
Appropriate immunizations and early treatment |
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Management for myocarditis |
Bedrest to decrease cardiac workload, avoid NSAIDs can damaged myocardium even more, manage symptoms of heart failure or dysrhythmias, anti embolism stockings |
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Inflammation of the pericardium |
Pericarditis |
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Causes of pericarditis |
Idiopathic, infection, hypersensitivity States, disorders of adjacent structures, neoplastic disease, radiation therapy of chest and upper torso, trauma, renal failure and uremia, sarcoidosis |
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Clinical manifestations of pericarditis |
Chest pain that worsens with deep inspiration and lying down or turning, friction rub, fever, increased white blood cell count, anemia, dyspnea, cough |
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Management of pericarditis |
Determine and treat underlying cause, bed rest, and sides, corticosteroids, pericardiocentesis where the fluid is removed, pericardial window where the small opening is made in the pericardium to allow continuous drainage into the chest cavity |
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Nursing management for pericarditis |
Pain management, reassurance that pain is not from a heart attack, position in forward-leaning or sitting position to relieve pain, assess with activity restrictions until pain and fever subside, and encourage gradual increase of activity after condition improves |
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Assessment with pericarditis |
Pain, pericardial friction rub(continues with holding breath), fever |
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Nursing interventions to relieve pain with pericarditis |
Rest, sitting upright in lean forward |
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Abnormal accumulation of fluid between the pericardial linings |
Pericardial effusion |
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Signs and symptoms begin with patient reporting shortness of breath, chest tightness or dizziness. There's May observe the patient is becoming progressively more Restless, decreased systolic blood pressure, jugular vein distention |
Cardiac tamponade |
