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Questions and Answers
What is the term used for the repair of a cardiac valve?
What is the surgical management option when valvuloplasty is not feasible for mitral regurgitation?
How are vital signs managed during the nursing care for valvuloplasty and valve replacement?
Which medication type is used to increase or decrease blood pressure during valvuloplasty or valve replacement?
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When are patients with mitral regurgitation advised to restrict their activity level?
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Which class of medications is used for afterload reduction in patients with mitral regurgitation and heart failure?
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What is the medical management approach for patients with mitral regurgitation and heart failure?
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In what cases is valve replacement performed instead of valvuloplasty for mitral regurgitation?
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What is the purpose of connecting the patient to the cardiopulmonary bypass (CPB) machine during a CABG procedure?
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What is the major purpose of a Coronary Artery Bypass Graft (CABG) procedure?
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What distinguishes off-pump coronary artery bypass (OPCAB) from traditional CABG procedures?
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What common complication is associated with traditional Coronary Artery Bypass Graft procedures?
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What are the major indications for Coronary Artery Bypass Graft (CABG)?
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What role does a beta-adrenergic blocker play in off-pump coronary artery bypass (OPCAB) surgeries?
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What factors are considered when determining the recommendation for Coronary Artery Bypass Graft (CABG)?
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What occlusion percentage is generally required in the coronary arteries to consider a patient for Coronary Artery Bypass Graft (CABG)?
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In preoperative nursing management for coronary artery bypass graft procedures, what type of testing is typically conducted?
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What is the recommended vessel to be used for Coronary Artery Bypass Graft (CABG)?
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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.
