Foundations Valvular Heart Disease Flash Cards

Heart Valves and Their Function

• Normal heart valves regulate blood flow through the heart and lungs, ensuring unidirectional movement from atria to ventricles.
• Valves open and close passively based on pressure changes within the heart.
• Major valves include the tricuspid (between right atrium and ventricle), pulmonary semilunar (right ventricle to lungs), mitral (left atrium to ventricle), and aortic semilunar (left ventricle to aorta).

Valvular Disease

• Occurs when heart valves fail to function properly, leading to inadequate blood flow.
• Common valvular issues include stenosis (narrowing of the valve) and insufficiency (inability to close completely).
• Conditions such as mitral stenosis, aortic stenosis, and tricuspid insufficiency represent various forms of valvular heart disorder.
• Risk factors include congenital conditions and a history of rheumatic fever, which may manifest 10 to 40 years later.

Clinical Symptoms

• Patients may experience symptoms like shortness of breath, fatigue, palpitations, and dizziness, often tied to decreased cardiac output.
• Objective assessments reveal possible heart murmurs, adventitious lung sounds, and swelling in extremities.

Diagnostic Tests for Valvular Heart Disease

• Chest radiograph, ECG, echocardiogram, and cardiac catheterization are key diagnostic tools.

Medical Management

• Treatment strategies include activity limitations, sodium-restricted diets, diuretics, and medications like digoxin.
• Surgical interventions may involve open mitral commissurotomy or valve replacement with various types of prosthetic valves.

Nursing Interventions

• Focus on assisting patients with activities of daily living, symptom management, and medication administration.
• Monitor vital signs and fluid balance, educating patients about their condition and the importance of follow-up appointments.

Prognosis

• Varies based on valvular conditions; surgical patients experience fair to good outcomes but may retain some abnormalities.

Rheumatic Fever and Its Consequences

• Sudden onset typically follows throat infections, potentially leading to long-term complications such as rheumatic heart disease.
• Symptoms may include chest pain and joint issues, which can lead to valvular dysfunction due to Aschoff’s nodules.

Pericarditis

• Inflammation of the pericardial sac; may be acute or chronic.
• Symptoms include severe chest pain that worsens with movement, dyspnea, and characteristic pericardial friction rub.

Endocarditis

• Infection of the heart's inner lining, primarily affecting heart valves.
• Symptoms include flu-like signs, petechiae, and embolic phenomena.
• Diagnosed via blood cultures and imaging exams; management focuses on antibiotics, rest, and monitoring for complications.

Conclusion

• Understanding valvular diseases, pericarditis, and endocarditis is essential for effective treatment and patient education. Regular monitoring and prompt intervention can significantly impact patient outcomes.### Infective Endocarditis
• Outpatient treatment has become more common due to versatile antibiotics and economic concerns.
• Prophylactic antibiotics are recommended for high-risk individuals, such as those with previous valve surgery or congenital heart defects.
• Precautions include antibiotic therapy before any invasive procedures, like dental work or minor surgeries.
• Severe cases may require surgical interventions, including valve repair or prosthetic valve replacement.
• Nursing care involves monitoring symptoms, maintaining a calm environment, regular vital sign checks, and ensuring proper nutrition.
• Patient education covers recognizing symptoms of infection, dietary needs, and the importance of prophylactic antibiotics.

Myocarditis

• Acute myocarditis is rare and can develop from various infections or conditions, most commonly coxsackie virus type B in the U.S.
• Early symptoms may resemble upper respiratory infections, followed by chest pain and heart failure indicators.
• Diagnosis involves imaging techniques and biopsies; treatment is symptomatic, similar to endocarditis management.
• Complications can include cardiomyopathy and dysrhythmias; early detection is vital for better outcomes.

Cardiomyopathy

• Definition: A group of heart muscle diseases affecting myocardium function and structure, not caused by CAD or hypertension.
• Classification includes primary (unknown causes) and secondary (identified causes like infections, nutritional deficiencies, and cardiotoxic substances).
• Types of primary cardiomyopathy:
  • Dilated: Most common, characterized by ventricular dilation.
  • Hypertrophic: Increased heart muscle mass and decreased chamber size.
  • Restrictive: Rigid ventricular walls causing diastolic filling issues.

Clinical Manifestations of Cardiomyopathy

• Common signs include angina, syncope, marked exercise intolerance, and symptoms of heart failure like dyspnea and edema.
• Diagnosis depends on clinical evaluation and a combination of noninvasive and invasive tests, including echocardiograms and biopsies.

Medical Management

• Treatment focuses on underlying causes and heart failure management using diuretics, ACE inhibitors, and beta-blockers.
• In advanced cases, cardiac transplantation may be necessary; about 50% of transplant recipients have cardiomyopathy.
• Evaluation for transplantation includes psychological assessments and physical examinations.

Cardiac Transplantation

• First performed in 1967, it's now the preferred treatment for end-stage heart disease.
• Patients remain on transplant lists until donor organs can be matched based on body size and blood type.
• Surgical procedure includes left and right atrial preservation and careful donor heart preparation.
• Post-transplant, immunosuppressive therapy is crucial to prevent rejection, using drugs like cyclosporine and corticosteroids.
• Complications like infections are significant concerns, making nursing care focused on prevention and patient education essential.

Prognosis

• Cardiomyopathy prognosis is poor, with many patients facing rapid decline and an estimated 50% mortality rate within two years.
• The survival rate post-cardiac transplant is approximately 81.8% at one year and 69.8% at five years, with increasing numbers of long-term survivors.