Cardiovascular System Pathology
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Questions and Answers

What is the term used for the repair of a cardiac valve?

  • Myocardial infarction
  • Valvuloplasty (correct)
  • Valvular stenosis
  • Cardiomyopathy
  • What is the surgical management option when valvuloplasty is not feasible for mitral regurgitation?

  • Perform cardiac ablation
  • Conduct angioplasty
  • Initiate heart transplant
  • Undertake valve replacement (correct)
  • How are vital signs managed during the nursing care for valvuloplasty and valve replacement?

  • Assess every hour
  • Assess every 5 to 15 minutes (correct)
  • Do not monitor vital signs
  • Assess every 30 minutes
  • Which medication type is used to increase or decrease blood pressure during valvuloplasty or valve replacement?

    <p>Intravenous (iv) medications</p> Signup and view all the answers

    When are patients with mitral regurgitation advised to restrict their activity level?

    <p>Once symptoms of heart failure develop</p> Signup and view all the answers

    Which class of medications is used for afterload reduction in patients with mitral regurgitation and heart failure?

    <p>Angiotensin converting enzyme (ACE) inhibitors</p> Signup and view all the answers

    What is the medical management approach for patients with mitral regurgitation and heart failure?

    <p>Treat with beta-blockers like carvedilol</p> Signup and view all the answers

    In what cases is valve replacement performed instead of valvuloplasty for mitral regurgitation?

    <p>When severe fibrosis immobilizes the valve components</p> Signup and view all the answers

    What is the purpose of connecting the patient to the cardiopulmonary bypass (CPB) machine during a CABG procedure?

    <p>To maintain blood circulation and oxygenation while the heart is stopped</p> Signup and view all the answers

    What is the major purpose of a Coronary Artery Bypass Graft (CABG) procedure?

    <p>To provide an alternative route for blood flow in the heart</p> Signup and view all the answers

    What distinguishes off-pump coronary artery bypass (OPCAB) from traditional CABG procedures?

    <p>The avoidance of connecting the patient to the CPB machine</p> Signup and view all the answers

    What common complication is associated with traditional Coronary Artery Bypass Graft procedures?

    <p>Arrhythmias</p> Signup and view all the answers

    What are the major indications for Coronary Artery Bypass Graft (CABG)?

    <p>Relief of chest pain that is not controlled with medication or PCI</p> Signup and view all the answers

    What role does a beta-adrenergic blocker play in off-pump coronary artery bypass (OPCAB) surgeries?

    <p>To stabilize the myocardium during surgery</p> Signup and view all the answers

    What factors are considered when determining the recommendation for Coronary Artery Bypass Graft (CABG)?

    <p>Number of diseased coronary vessels</p> Signup and view all the answers

    What occlusion percentage is generally required in the coronary arteries to consider a patient for Coronary Artery Bypass Graft (CABG)?

    <p>At least 70%</p> Signup and view all the answers

    In preoperative nursing management for coronary artery bypass graft procedures, what type of testing is typically conducted?

    <p>Blood typing and cross matching</p> Signup and view all the answers

    What is the recommended vessel to be used for Coronary Artery Bypass Graft (CABG)?

    <p>Internal mammary artery</p> Signup and view all the answers

    Study Notes

    Mitral Valve Disorders

    • Mitral Regurgitation: blood flows back from the left ventricle into the left atrium during systole due to thickened and fibrosed mitral valve leaflets and chordae tendineae, resulting in incomplete closure.
    • Causes: degenerative changes, ischemia of the left ventricle, rheumatic fever, infective endocarditis, cardiomyopathy.
    • Pathophysiology: backward flow of blood from the ventricle decreases blood flow from the lungs into the atrium, causing congestion in the lungs and extra strain on the right ventricle.
    • Clinical manifestations: dyspnea, fatigue, weakness, palpitations, shortness of breath on exertion, cough from pulmonary congestion.
    • Assessment and diagnostic findings: systolic murmur at the apex, irregular pulse (atrial fibrillation), echocardiography.

    Mitral Stenosis

    • Definition: progressive thickening and contracture of the mitral valve leaflets and chordae tendineae, causing narrowing of the orifice and progressive obstruction to blood flow.
    • Causes: rheumatic endocarditis, congenital heart defects, aging.
    • Pathophysiology: left atrium dilates and hypertrophies due to difficulty moving blood into the ventricle, and pulmonary circulation becomes congested.
    • Signs and symptoms: dyspnea on exertion, progressive fatigue, hemoptysis, cough, wheezing, repeated respiratory infections, weak and irregular pulse.
    • Assessment and diagnostic findings: weak and irregular pulse (atrial fibrillation), low-pitched, diastolic murmur at the apex, echocardiography, electrocardiography (ECG), exercise testing, cardiac catheterization with angiography.

    Coronary Artery Bypass Graft (CABG)

    • Definition: surgical procedure in which a blood vessel is grafted to an occluded coronary artery to restore blood flow to the heart.
    • Purposes: restore blood flow to the heart, relieve chest pain and ischemia, improve quality of life, lower the risk of heart attack.
    • Indications: uncontrolled angina, left main coronary artery stenosis or multi-vessel CAD, prevention of MI, dysrhythmias, or heart failure, treatment for complications from an unsuccessful PCI.
    • Procedure: median sternotomy, cardiopulmonary bypass (CPB) machine, grafting a blood vessel (e.g., saphenous vein, left internal mammary artery) distal to the coronary artery lesion.
    • Alternative: off-pump coronary artery bypass (OPCAB) without CPB, using a myocardial stabilization device to hold the site still for anastomosis of the bypass graft into the coronary artery.

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    Description

    Learn about the consequences of blood regurgitation in the cardiovascular system, including atrial stretching and hypertrophy, pulmonary congestion, and strain on the right ventricle.

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