Diseases of heart valves

1. SCHOOL OF NURSING
DEPARTMENT OF MEDICAL SURGICAL NURSING
GROUP ASSIGNMENT
GROUP MEMBERS
1. Menber Yilma. GSRC/4257/
2. Nardos.Denekew GSRC/4259/15
3. Tewodros Ayele GSRC/4263/15
Submited to :- Instructor Tekalgn. ( Msc.CVPN)
June 30/2023
AA, Ethiopia

2. Acknowledgement
We would ike to.express.our deep gratitude to
Instructor Tekalgn for his commitment and
guiding.us.to be.much familiar and skilled in
Cardiovascular nursing care.

3. Out line
• Mitral Valve Prolaps
• Mitral Valve Regurgitation
• Mitral Valve Stenosis
• AorticValve regurgitation
• Aortic Valve Stenosis
• Nursing Mngement of Valvular heart disese.

4. Mitral Valve
1

5. Heart Chambers and Valves
2

6. Overview
• The mitral valve is located between the left atrium
and the left ventricle and is composed of two flaps.
• They are anchored to the walls of the ventricles
by chordae tendineae, which prevent them from
inverting.
• The chordae tendineae are attached to papillary
muscles that cause tension to better hold the valve
3

7. Cont...
• Together, the papillary muscles and thechordae
tendineae are known as the subvalvular apparatus.
• The function of the subvalvular apparatus is to
keep the valves from prolapsing into the atria when
they close
4

8. Mitral Valve Function
• It allows the blood to flow from the left atrium into
the left ventricle
• During diastole, a normally-functioning mitral valve
opens as a result of increased pressure from the left
atrium as it fills with blood (preloading).
• Opening facilitates the passive flow of blood into the
left ventricle.
• The mitral valve closes at the end of atrial contraction
to prevent a back flow of blood.
• 5

9. Mitral Valve Prolapse
• Is the bulging of one or both of the mitral
valve flaps (leaflets) into the left atrium during
contraction of the heart.
• Cause of Mitral Valve Prolapse is unknown,
but is thought to be linked to heredity.
6

10. Sign and Symptoms
Includes
• Chest pain
• Mitral regurgitation
• Irregular heartbeat (arrhythmia)
• Dizziness or lightheadedness
• Shortness of breath, especially during exercis
when lying flat
• Fatigue
• Syncope
• Palpitation 7

11. Risk Factors
• Men older than 50 years old
• HTN
• Graves' disease.
• Marfan syndrome.
• Muscular dystrophy.
• Scoliosis.
•
•
8

12. Complications
• Mitral Valve regurgitaion
.
• Heart rhythm problems (arrhythmias).
9

13. 10

14. Mitral Valve Prolapse ECG Finding
• inversion of T wave
• Enlarged LA
• Atrial Fibrilation
11

15. 12

16. Mitral Valve Echo finding
• To confirm mitral valve prolapse and severity
• Thickend leaflets greater than 5mm.
• Leaflet displacement >2mm
13

17. Mitral Valve Prolapse treatment
• Exercise
• Pain relievers
• Relaxation and stress reduction techniques
• Avoidance of caffeine and other stimulants
• Beta-blockers
•
• 14

18. Follow-Up of Mitral Valve Prolapse
• Most people with mitral valve prolapse should
see a cardiologist every 2 to 3 years. They do
not need regular echocardiograms.
• People with mitral valve prolapse and
moderate or severe mitral regurgitation should
see a doctor and undergo echocardiography
every 6 to 12 months.
• Echocardiography and a doctor's visit are also
recommended if a person develops new
symptoms, or if the symptoms change.
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19. Mitral Valve Regurgitation
16

20. Overview
• MR is a type of heart valve disease in which the
valve between the left heart chambers doesn't
close completely, allowing blood to leak
backward across the valve.
• It is the most common type of heart valve
disease (valvular heart disease).
• If the leakage is severe, not enough blood will
move through the heart or to the rest of the body.
As a result, mitral valve regurgitation can make
you feel very tired (fatigued) or short of breath
17

21. Cont...
• If mitral valve regurgitation is due to problems
with the mitral valve, the condition is called
primary mitral valve regurgitation.
• If a problem or disease affecting other areas of
the heart cause a leaky mitral valve, the
condition is called functional or secondary
mitral regurgitation.
•
•
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22. Causes
• Mitral.Degenaration
• Mitral prolaps
• Rheumatic valvular disease
• Endocarditis
• Congenital mitral regurgitation
• Rupture of Chordate tendane
• Rupture os Papillary muscle
• Dialated cardiomayopathy
• Ischemic heart disease
19

23. Symptoms
• Fatigue
• heart murmur
• Irregular heartbeat (arrhythmia)
• (dyspnea) (Orthopnea)
• (palpitations)
• edema
20

24. Risk factors
• Infections that affect the heartHeart attackHeart
• Congenital heart defect
• History of other heart valve diseases, including
mitral valve prolapse and mitral valve stenosis
• Older age
• Radiation to the chest
21

25. Complications
• Irregular and often rapid heart rate (atrial
fibrillation).
• High blood pressure in the lungs (pulmonary
hypertension).
• CHF
22

26. ECG and Echo Findings
• ECG FINDING
 Broad P wave indicating left atrium enlargment
 occurs due to the increased time required for propagation of
electrical activity throughout the enlarged left atrium.
23

27. Echho finding of Mitral
redurgitation
• blood flowing from LV to LA during systol
• Detect dialated left atrium and ventricle
24

28. Staging
Heart valve disease is staged into four basic groups:
• Stage A: At risk.
Risk factors for heart valve disease are present.
• Stage B: Progressive.
Valve disease is mild or moderate. There are no heart
valve symptoms
• Stage C: Asymptomatic severe.
There are no heart valve symptoms, but the valve
disease is severe
• Stage D: Symptomatic severe.
• Heart valve disease is severe and is causing symptoms.
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29. Mitral Stenosis
26

30. Defnition
• Narrowing of the valve between the two left
heart chambers.
• The narrowed valve reduces or blocks blood
flow into the Left Ventricle.
27

31. Causes
• Rheumatic fever.
• Calcium deposits
• Radiation therapy
28

32. • Shortness of breath,
especially with activity
• Orthopnea
• Fatigue, especially
during increased activity
• Swollen feet or legs
• Sensations of a fast,
fluttering or pounding
heartbeat
• Dizziness or fainting
• Irregular heart sound,
also called a heart
murmur
• Fluid buildup in the
lungsI
• rregular heart rhythms
• Chest discomfort or
chest pain
• hemaptosis
Symptoms
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33. Risk factors
• Untreated strep infections
• Aging
• Radiation Therapy
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34. Complications
• Irregulr heart beat
• Blood clot
• High blood pressure in the lung arteries
• Right side heart failure
31

35. ECG findings
• There is atrial fibrillation.
• No P waves are visible.
• The rhythm is irregularl.
• There is the suggestion of right ventricular
hypertrophy.
• Right axis deviation and deep S waves in the
lateral leads.
32

36. 33

37. Echo Finding
• Reduced mitral valve area <1.5mm➋
• Thickened Calcified leaflets
• Increased mean diastolic preasure gradient
across the mitrl valve
• Right Ventricle dialtion
• Left Atrium Enlargment
• Evidences of Pulmonary hypertension
34

38. Treatment
• provide prophylaxis for infective endocarditis
• reduce symptoms of pulmonary congestion
(eg, orthopnea, paroxysmal nocturnal dyspnea)
• control the ventricular rate if atrial fibrillation is
present, and
• prevent thromboembolic complications
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39. Aortic valve regurgitation
36

40. Defnition
• a condition that occurs when aortic valve
doesn't close tightly.
• As a result, some of the blood pumped out of
theft ventricl leaks backward.
37

41. Symptoms
• Shortness of breath with exercise or when you lie down
• Fatigue and weakness, especially when you increase
your activity leve
• lHeart murmur
• Irregular pulse (arrhythmia)
• Lightheadedness or fainting
• Chest pain (angina),
• discomfort or tightness, often increasing during exercise
• Palpitations
• Leg swelling
38

42. Causes
Causes of aortic valve regurgitation include
• Congenital heart valve disease.
• Narrowing of the aortic valve (aortic stenosis).
• Inflammation of the lining of the heart's
chambers and valves (endocarditis)
• Rheumatic fever
39

43. Risk factors
• Older age
• Congenital heart disease
• History of infections that can affect the heart
• Conditions that can affect the heart, such as
Marfan syndrome
• Valve conditions, such as aortic valve stenosis
• High blood pressure
40

44. Complications
• Fainting
• feeling lightheaded
• Heart failure
• Heart rhythm problems (arrhythmias)
• Death
41

45. ECG finding
• Left Ventricular hypertrophic
• T wave inversion
42

46. Echo Finding
• Dialated LV
43

47. Treatment
• Antibiotics
• Aortic valve repair
• Aortic valve replacement
• BP lowering medications
• Anticuagulant
• Blood thiner
44

48. Aortic valve stenosis
45

49. Defnition
• Narrowing of the Aortic valve resulting in
Obstruction of blood flow from the left ventricle
to aorta during systole.
46

50. Symptoms
Symptoms of aortic valve stenosis may include
• An irregular heart sound (heart murmur) heard
through a stethoscope
• Chest pain (angina) or tightness with
activityFeeling faint or dizzy or fainting with
activity
• Shortness of breath, especially with
activityFatigue, especially during times of
increased activityRapid, fluttering heartbeat
• palpitations
• Thrill
• Weight lose
47

51. Causes
• CHF
• Calcium buildup on the valve (aortic valve
calcification)
• Fibrosis
• Rheumatic fever
• Congenital Bicusped aortic valve
• Degerarative disease
48

52. Risk factors
Risk factors of aortic valve stenosis include:
• Older age
• Congenital heart defects, such as a bicuspid aortic
valve
• Chronic kidney disease
• Having heart disease risk factors, such as diabetes,
high cholesterol and high blood pressure
• History of Rheumatic fever and infective endocarditis
• History of radiation therapy to the chest
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53. Complications
Aortic valve stenosis can cause complications,
including:
• Heart failure
• Stroke
• Blood clots
• Bleeding
• Irregular heart rhythms (arrhythmias)
• Infections that affect the heart, such as endocarditis
• HTN
• Death
50

54. ECG finding
• LVH
• LBBB
• Complete heart block
51

55. 52

56. • Aortic valve with no
cusp motion (may be
unreliable in congenital
or rheumatic valvular
stenosis)
• A decrease in the
maximal aortic cusp
separation (< 8 mm in
the adult)
• The presence of
unexplained LV
hypertrophy
Echo Finding
53

57. NursingManagement of
Valvular heart Diseases
54

58. • Assess mental status (Restlessness, severe anxiety,
and confusion).
• Check vital signs (heart rate and blood pressure).
• Assess heart sounds, noting gallops, S3, S4.
• Assess manually peripheral pulses (with weak rate,
rhythm indicated low cardiac output).
• Assess lung sounds and determine any occurrence
of Paroxysmal Nocturnal Dyspnea (PND) or
orthopnea.
• Monitor central venous, right arterial pressure [RAP],
pulmonary arterial pressure(PAP) Routinely
55

59. • Assess skin color and temperature (Cold, clammy skin
is secondary to a compensatory increase in
sympathetic nervous system stimulation and low
cardiac output and desaturation).
• Carefully maintain intake output and daily check
weight.
• Administer medication as prescribed, noting response,
and watching for side effects and toxicity.
• Administer stool softeners as needed(straining for a
bowel movement further impairs cardiac output).
• Explain the drug regimen, purpose, dose, and side
effects.
• Maintain adequate ventilation and perfusion (Place the
patient in semi- to high-Fowler’s position or supine
position).
56

60. • Administer O2 as ordered.
• Assess response to increased activity and help the
patient in daily activities.
• Maintain physical and emotional rest (restrict activity
and provide a quiet and relaxed environment)
• Monitor sleep patterns; administer a sedative
• If invasive adjunct therapies are indicated (e.g.,
intra-aortic balloon pump, pacemaker), maintain
within the prescribed protocol, and prepare the
patient.
• Explain diet restrictions (fluid, sodium).
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61. References
1. https://www.mayoclinic.org/diseases-
conditions/mitral-valve-regurgitation/symptoms-
causes/syc-20350178
2. https://www.mayoclinic.org/diseases-
conditions/mitral-valve-stenosis/diagnosis-
treatment/drc-20353165
3. https://www.amboss.com/us/knowledge/mitral-
valve-stenosis
4. https://www.mayoclinic.org/diseases-
conditions/aortic-valve-regurgitation/diagnosis-
treatment/drc-20353135
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62. Cont...
5 . https://www.mayoclinic.org/diseases-
conditions/aortic-stenosis/diagnosis-
treatment/drc-20353145
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63. THANK YOU!
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