valvular heart disease for B.Sc. nursing course

1. VALVULAR HEART DISEASE
BY
MR.RAVISHANKAR
NURSING TUTOR
OJASWINI NURSING COLLEGE, SAGAR

2. INTRODUCTION:-
In heart valve disease, one or more of the valves in your heart doesn't
work properly. Your heart has four valves that keep blood flowing in the
correct direction. In some cases, one or more of the valves don't open or
close properly. This can cause the blood flow through your heart to your
body to be disrupted.

3. DEFINITION:-
An acquired or congenital disorder of cardiac valve
characterized by stenosis (obstruction) or backward flow
of blood.

4. • Defined according to the valve or valves affected and type of functional
alteration.
Includes
Stenosis (obstruction)
Regurgitation (backward flow of blood)

5. TYPES OF VALVE DISEASE
• Stenosis- valve doesn't open all the way, not enough blood passes
through.
• Regurgitation- valve doesn't close all the way so blood leaks
backwards.

6. Stenosis- valve orifice is smaller, impending the forward flow
of blood and creating a pressure gradient difference across an
open valve.
Regurgitation- incomplete closure of valve leaflets results in
the backward flow of blood.

7. MITRAL STENOSIS:-
Most common valvular disorder in rheumatic fever.
May also be caused by bacterial, infection, thrombus
formation.
Obstruct blood flow from left atrium to the left ventricle.

8. PATHOPHYSIOLOGY
Narrowing of mitral valve
Increase Left atrial pressure
Decrease blood flow to left ventricle
Increase Pulmonary pressure
Pulmonary congestion
Decrease O2 (fatigue)
Right side failure

9. CLINICAL MANIFESTATION:-
Exertional dyspnea (not being able to breathe fast or deeply enough during
physical activity)
Fatigue
Loud first heart sound
Low pitch diastolic murmur
Hoarseness of voice
Chest pain
Seizures or a stroke

10. MITRAL REGURGITATION:-
Incomplete closure of the mitral valve.
Rheumatic disease is the predominant cause.
May also be due to congenital anomaly, infective
endocarditis.

11. ETIOLOGY:-
Myocardial infarction.
Chronic rheumatic heart disease.
Mitral valve prolapse.
Infective endocarditis.

12. CLINICAL MANIFESTATION:-
Fatigue
Weakness
Dyspnea & cough
Palpitation due to atrial fibrillation
Right side heart failure
Distended Neck veins, edema
High pitched systolic murmur

13. MITRAL VALVE PROLAPSE

14. CAUSES:-
• Inherited connective tissue disorder – enlargement of one or both valve
leaflets.

15. CLINICAL MANIFESTATION:-
Palpitations
chest pain
Dyspnea (shortness of breath)
Do not respond to antianginal treatment.

16. AORTIC STENOSIS
Aortic stenosis — is a type of heart valve disease (valvular
heart disease). The valve between the lower left heart chamber
and the body's main artery (aorta) is narrowed and doesn't open
fully. This reduces or blocks blood flow from the heart to the
aorta and to the rest of the body.

17. ETIOLOGY

18. PATHOPHYSIOLOGY:-
Due to etiological factor
Narrowing of artic valve
Incomplete emptying of left atrium
Pulmonary congestion
Decrease O2 supply
Myocardial ischemia (chest pain)
Aortic stenosis

19. CLINICAL MANIFESTATION:-
Fatigue
Chest pain
Vertigo
Weakness
Pulmonary edema
Pulmonary congestion
Harsh auscultation

20. AORTIC REGURGITATION:-

21. CAUSES:-
Rheumatic fever is most common cause.
Severe hypertension
Congenital anomaly.
Connective tissue disease.

22. CLINICAL MANIFESTATION:-
Tachycardia(rapid heart rate)
Dyspnea (shortness of breath)
Chest pain- myocardial ischemia
Left heart failure
Fatigue
Peripheral edema

23. DIAGNOSTIC EVALUATION
History and physical examination
Echocardiogram
Cardiac catheterization
Electrocardiogram
Chest x-ray

24. MANAGEMENT:-
Antibiotic therapy (rheumatic fever, infective endocarditis)
Vasodilators
Beta blockers
Diuretics
Low sodium diet should be prescribed
Anticoagulant therapy to treat pulmonary embolization

25. SURGICAL MANAGEMENT:-
Valvuloplasty- is repair of cardiac valve. Patient does not
require continuous anti-coagulant medication.Usually require
cardiopulmonary bypass machine.

26. ANNULOPLASTY-
It is repair of valve annulus ( junction of the valve leaflet and
the muscular heart wall). Narrows the diameter of the valve's
orifice, useful for valvular regurgitation.

27. CHORDOPLASTY-
Is repair of chordae tendineae. Done for mitral valve
regurgitation- caused by stretched or shortened chordae
tendineae.

28. NURSING MANAGEMENT:-
•Assess the high risk patient.
•Monitor ECG
•Assess the family history of heart disease.
•Assess the history of smoking and alcoholism.
•Monitor vital sign.
•Instruct to avoid high fat and oil rich diet.