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69 Cards in this Set

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Causes of mitral valve prolapse

Most causes unknown what may be inherited so first-degree relatives need Echo

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)

Management for mitral valve prolapse

Control symptoms, eliminate caffeine and alcohol stop smoking, anti-arrhythmic medications

Portion of one or both mitral valve leaflets balloons back into the atrium during systole.

Mitral valve prolapse

Blood flowing back from left ventricle to left atrium during systole

Mitral regurgitation

Most common cause of mitral regurgitation

Degenerative changes of the mitral valve, ischemia of the left ventricle

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

Management for mitral regurgitation

Same as heart failure( ACE inhibitors, arbs, beta blockers), restrict activity level to minimize symptoms

An obstruction to blood flowing from the left atrium to the left ventricle most often caused by Rheumatic endocarditis

Mitral stenosis

Clinical manifestations for mitral stenosis

Dyspnea on exertion, fatigue, cough, palpitations, paroxysmal nocturnal dyspnea so, we can regular pulse. Diagnosed with Echo

Prevention for mitral stenosis

Minimizing risk of and treatment for bacterial infections

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

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

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

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

Narrowing of the orifice between the left ventricle and aorta. Often a result from degenerative changes and calcifications

Aortic stenosis

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

Prevention of aortic stenosis

Control risk factors for proliferative and inflammatory responses through treating diabetes hypertension cholesterol and triglycerides and avoiding tobacco products

Management for aortic stenosis

Medications to treat dysrhythmias or left ventricular failure. Definitive treatment is surgical replacement of the aortic valve.

Repair of a cardiac valve

Valvuloplasty

Anticoagulation with valvuloplasty

Anticoagulation for 3 months

Most common valvuloplasty procedure, separate fuse leaflets. Can we closed performed in the cath lab or open in open heart surgery

Commissurotomy

Repair of valve annulus. Open heart procedure. Under general anesthesia and cardiopulmonary bypass.

Annuloplasty

Repair of elongated ballooning or excess tissue leaflets. Open procedure

Leaflet repair.

Repair of chordae tendineae.

Chordoplasty

More durable valves often used for younger patients or for patients with renal failure hypercalcemia endocarditis or sepsis. Require long-term anticoagulation

Mechanical valves

Valves less likely to generate thromboemboli. No long-term anticoagulant required

Tissue valves

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

Valves used for aortic and pulmonic valve replacement from donation. Very expensive. Last 10 to 15 years

Homograft or allograft tissue valve

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

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

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

Disease of the heart muscle that is associated with cardiac dysfunction

Cardiomyopathy

Most common form of cardiomyopathy. Distinguish by significant dilation of ventricles without simultaneous hypertrophy

Dilated cardiomyopathy

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

Cardiomyopathy characterized by diastolic dysfunction caused by Ridgid ventricular walls that impaired diastolic filling and ventricular stretch

Restrictive cardiomyopathy

Rare cardiomyopathy where heart muscle asymmetrically increases especially along the septum

Hypertrophic cardiomyopathy

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

Medical management for cardiomyopathies

Directed toward identifying and managing possible underlying or precipitating cause

Management to correct heart failure with cardiomyopathy

Medications, low sodium diet, exercise and rest, fluid restrictions

Low sodium diet

Avoid process canned foods, TV dinners, lunch meat or hot dogs, pretzels, peanuts and table salt

Management to control dysrhythmias with cardiomyopathy

Anti-arrhythmic medications, implantable cardioverter-defibrillator, anticoagulation, pacemaker

Surgical management for cardiomyopathy

Myectomy which is removing some of the muscle or left ventricular outflow tract which helps move the blood along

Steps to prevent rejection of heart transplant

Lifelong immunosuppressants

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

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

Education with cardiomyopathy

Educate up medications, symptom monitoring and symptom management

Caused by acute rheumatic fever that may develop after an episode of group a beta hemolytic streptococcus pharyngitis

Rheumatic endocarditis

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

Heart changes from Rheumatic endocarditis

Murmur, thrill, dysrhythmias, heart failure, pericarditis, clots

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

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

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

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

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

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

Causes of myocarditis

Viral bacterial fungal and parasitic infections

Manifestations of myocarditis

Fatigue, dyspnea, syncope, palpitations, occasional discomfort in the chest and upper abdomen. Most common symptoms are flu-like

Prevention of myocarditis

Appropriate immunizations and early treatment

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

Inflammation of the pericardium

Pericarditis

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

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

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

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

Assessment with pericarditis

Pain, pericardial friction rub(continues with holding breath), fever

Nursing interventions to relieve pain with pericarditis

Rest, sitting upright in lean forward

Abnormal accumulation of fluid between the pericardial linings

Pericardial effusion

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