for nursing faculty

1. MR. SAGAR M………

2. ANATOMY AND PHY…

4. overview
 The mitral valve is located on the left side of your
heart, between two chambers: the atrium and
the ventricle.
 The atrium is the upper chamber, and the ventricle
is the lower chamber. Blood is pumped from the
left atrium, through the mitral valve, and into the
left ventricle on its way to the aorta.
 The healthy mitral valve allows blood to pass
through, but prevents it from flowing back.

5. INTRODUCTION AND
DEFINATION
 Mitral valve stenosis, also known as mitral stenosis,
occurs when the mitral valve opening is narrowed.
This means that not enough blood can flow through
it.
 Mitral stenosis is a valvular heart
disease characterized by the narrowing of the orifice
of the mitral valve of the heart
 Mitral valve stenosis can lead to a variety of issues,
including fatigue, difficulty breathing, blood clots,
and heart failure.

6. Etilogical factors….
 Mitral valve stenosis is typically caused by
rheumatic fever.
 Pericarditis
 Myocarditis
 Endocarditis
 Congenital heart defect
 Other: tumour, blood clot, radiation therapy

7. C/M
 Mitral valve stenosis commonly leads to shortness
of breath, especially during exercise or when lying
down.
 Other common symptoms include:
 Hemoptysis
 chest pain
 fatigue
 swelling in the ankles or feet
 respiratory infections
 Ascitis, edema, hepatomegaly
 If mitral valve stenosis is severe,
heart fluttering or beating rapidly.

8. D/E
 Physical examination: heart
murmur, arrhythmia, and fluid in the lungs are
all indicators of mitral valve stenosis.
 Chest x ray
 ECG/ Echocardiogram
 Cardiac chamber catheterization

9. Management
 anticoagulants, or blood thinners, to reduce
the risk of blood clots
 diuretics to reduce fluid buildup through
increased urine output
 antiarrhythmics to treat abnormal heart
rhythms
 beta-blockers to slow your heart rate
 Vuivoplasty:
 mitral balloon valvuloplasty.

10. Mitral Regurgitation
 Mitral valve regurgitation — also called mitral
regurgitation, mitral insufficiency or mitral
incompetence — is a condition in which heart's
mitral valve doesn't close tightly, allowing
blood to flow backward in heart.

11. Causes…
 Mitral valve prolapse. In this condition, the
mitral valve's leaflets bulge back into the left
atrium during the heart's contraction.
 Rheumatic fever.
 Endocarditis.
 Heart attack.
 Trauma. Experiencing trauma, such as in a
car accident, can lead to mitral valve
regurgitation

12. Causes…
 Congenital heart defects.
 Certain drugs.
 Radiation therapy.
 Atrial fibrillation.
 HEART DISEASE: CAD
 Advanced age..

13. C/M..
 Some people with mitral valve disease might
not experience symptoms for many years.
 Abnormal heart sound (heart murmur) heard
through a stethoscope
 Shortness of breath (dyspnea),
 Fatigue
 Heart palpitations — sensations of a rapid,
fluttering heartbeat
 Swollen feet or ankles

14. D/E
 Echocardiogram
 ECG
 Chest X ray
 Cardiac MRI
 Cardiac CT
 Cardiac catheterization..

15. Management…
 Medications may include:
 Diuretics. These medications can relieve fluid
accumulation in your lungs or legs, which can
accompany mitral valve regurgitation.
 Blood thinners. These medications can help
prevent blood clots and may be used if you have
atrial fibrillation.
 High blood pressure medications. High blood
pressure makes mitral valve regurgitation worse,
so if you have high blood pressure, your doctor
may prescribe medication to help lower it.

16. Surgery…
 Mitral valve repair
 Surgeons can repair the valve by reconnecting
valve flaps (leaflets), replacing the cords that
support the valve, or removing excess valve
tissue so that the leaflets can close tightly.
Surgeons may often tighten or reinforce the
ring around a valve (annulus) by implanting an
artificial ring (annuloplasty band).

17. Surgery..
 Mitral valve replacement
 If your mitral valve can't be repaired, you may
need mitral valve replacement. In mitral valve
replacement, your surgeon removes the
damaged valve and replaces it with a
mechanical valve or a valve made from cow,
pig or human heart tissue (biological tissue
valve).

18. Health Education….

20. Introduction…
 Tricuspid stenosis (TS) is narrowing of the
tricuspid orifice that obstructs blood flow
from the right atrium to the right ventricle.
 Tricuspid stenosis is almost always due
to rheumatic fever;
 Rare causes of tricuspid stenosis include SLE,
right atrial (RA) myxoma, congenital
malformations, and metastatic tumors.

21. s/s
 The only symptoms of severe tricuspid
stenosis are fluttering discomfort in the neck
(due to giant a waves in the jugular pulse),
 fatigue and cold skin (due to low cardiac
output), and
 right upper quadrant abdominal discomfort
(due to an enlarged liver).
 Jugular venous distention may occur,
increasing with inspiration (Kussmaul sign).

22. D/E
 Echo/ ECG
 Chest x ray
 Liver enzymes
 Cardiac catheterization

23. Treatment…
 Diuretics
 vulvoplasty

25. Definition…
 Tricuspid insufficiency (TI), also
called tricuspid regurgitation (TR), is a type
of valvular heart disease where there is failure
of the heart's tricuspid valve to close properly
when the ventricles contracts.

27. Etiological factors…
 Infective endocarditis.
 Carcinoid syndrome. In this rare condition,
tumors that develop in your digestive system
and spread to your liver or lymph nodes
produce a hormonelike substance that can
damage heart valves, most commonly the
tricuspid valve and pulmonary valves.
 Implantable device wires (leads)
 Endomyocardial biopsy.
 Blunt chest trauma.

28. Etiological factors…
 Rheumatic fever.
 Congenital heart defects.
 Marfan syndrome. Marfan syndrome, a
genetic disorder of connective tissue present
at birth, is occasionally associated with
tricuspid valve regurgitation.
 Radiation. Chest radiation may damage the
tricuspid valve and cause tricuspid valve
regurgitation.

29. C/M…
 Noticeable signs and symptoms of tricuspid
valve regurgitation may include:
 Fatigue
 Declining exercise capacity
 Swelling in your abdomen, legs or veins in
your neck
 Abnormal heart rhythms
 Pulsing in your neck
 Shortness of breath with activity
 decreased urine output

30. D/E
 Echocerdiogram
 ECG
 Chest x ray
 Cardiac MRI
 Cardiac CT
 Cardiac catheterization..

31. Management….
 Diuretics
 Surgical valve repair or replacement..

33. Definition….
 Aortic valve stenosis — or aortic stenosis —
occurs when the heart's aortic valve narrows.
This narrowing prevents the valve from
opening fully, which reduces or blocks blood
flow from heart into the main artery to body
(aorta) and onward to the rest of your body.

34. Causes and risk factors..
 Congenital heart defect
 Rheumatic fever
 Aortic valve calcification
 Older age
 History of infection
 Diabetics, high cholesterol, high blood
pressure
 Chronic kidney disease
 History of radiation therapy on chest

35. s/s
 Abnormal heart sound (heart murmur) heard through
a stethoscope
 Chest pain (angina) or tightness with activity
 Feeling faint or dizzy or fainting with activity
 Shortness of breath, especially when you have been
active
 Fatigue, especially during times of increased activity
 Heart palpitations — sensations of a rapid, fluttering
heartbeat
 Not eating enough (mainly in children with aortic valve
stenosis)
 Not gaining enough weight (mainly in children with
aortic valve stenosis)

36. D/E
 Echocardiogram.
 Electrocardiogram (ECG).
 Chest X-ray
 Exercise tests or stress tests.
 Cardiac computerized tomography (CT)
scan.
 Cardiac MRI.
 Cardiac catheterization.

37. Management..
 Aortic valve repair
Surgeons rarely repair an aortic valve to treat
aortic valve stenosis, and generally aortic
valve stenosis requires aortic valve
replacement. To repair an aortic valve,
surgeons may separate valve flaps (cusps)
that have fuse

38.  Balloon valvuloplasty
 Doctors may conduct a procedure using a long,
thin tube (catheter) to repair a valve with a
narrowed opening (aortic valve stenosis). In this
procedure, called balloon valvuloplasty, a doctor
inserts a catheter with a balloon on the tip into an
artery in your arm or groin and guides it to the
aortic valve. The doctor performing the procedure
then inflates the balloon, which expands the
opening of the valve. The balloon is then deflated,
and the catheter and balloon are removed.

39.  Aortic valve replacement
 Mechanical valve replacement
 Aortic valve replacement is often needed to
treat aortic valve stenosis. In aortic valve
replacement, your surgeon removes the
damaged valve and replaces it with a
mechanical valve or a valve made from cow,
pig or human heart tissue (biological tissue
valve).

40. Complication…
 Aortic valve stenosis can cause complications,
including:
 Heart failure
 Stroke
 Blood clots
 Bleeding
 Heart rhythm abnormalities (arrhythmias)
 Infections that affect the heart, such as
endocarditis
 Death

41. Prevention…
 Eating a heart-healthy diet. Eat a variety of fruits and
vegetables, low-fat or fat-free dairy products, poultry, fish, and
whole grains. Avoid saturated and trans fat, and excess salt
and sugar.
 Maintaining a healthy weight. Aim to keep a healthy weight.
If you're overweight or obese, your doctor may recommend
that you lose weight.
 Getting regular physical activity. Aim to include about 30
minutes of physical activity, such as brisk walks, into your
daily fitness routine.
 Managing stress. Find ways to help manage your stress,
such as through relaxation activities, meditation, physical
activity, and spending time with family and friends.
 Avoiding tobacco. If you smoke, quit. Ask your doctor about
resources to help you quit smoking. Joining a support group
may be helpful.

42. Definition…
 Aortic insufficiency (AI), also known
as aortic regurgitation (AR), is the leaking of
the aortic valve of the heart that causes blood
to flow in the reverse direction during
ventricular diastole, from the aorta into the left
ventricle.

43. Causes…
 congenital valve defects, which are defects you’re
born with
 infections of the heart tissue
 high blood pressure
 genetic conditions such as Marfan’s syndrome,
which affects the connective tissues
 untreated syphilis
 lupus
 heart aneurysms
 ankylosing spondylitis, which is a form
of inflammatory arthritis

44. Signs and symptoms
Dyspnea on exertion
 Orthopnea
 Palpitations
 Angina pectoris
 Cyanosis (in acute cases)
 weakness
 fainting
 swollen ankles and feet

45. Diagnostic measures…
 a chest X-ray to spot enlargement of the left
ventricle, which is typical of heart disease
 an electrocardiogram (EKG) to measure the
electrical activity of the heart, including the rate
and regularity of heartbeats
 an echocardiogram to view the condition of
the heart chambers and heart valves
 cardiac catheterization to assess the
pressure and flow of blood through the heart
chambers.

46. Treatment…
 Repair or replace the aortic valve.

47. DEFINITION…
 Pulmonary valve stenosis is a condition in
which a deformity on or near your pulmonary
valve narrows the pulmonary valve opening
and slows the blood flow. The pulmonary valve
is located between the lower right heart
chamber (right ventricle) and the pulmonary
arteries.

48.  Carcinoid syndrome. This syndrome — a
combination of signs and symptoms, including
flushing of the skin and diarrhea — results
from the release of a chemical, serotonin, from
growths called carcinoid tumors in the
digestive system.
 Rheumatic fever. This complication of an
infection caused by streptococcus bacteria,
such as strep throat, may injure the heart
valves.

49.  Noonan syndrome is a disorder that involves
unusual facial characteristics, short stature,
heart defects present at birth, bleeding
problems, developmental delays, and
malformations of the bones of the rib
cage. Noonan syndrome is caused by
changes in one of several autosomal dominant
genes.

50. SYMPTOMS..
 Heart murmur — an abnormal whooshing
sound heard using a stethoscope, caused by
turbulent blood flow
 Fatigue
 Shortness of breath, especially during exertion
 Chest pain
 Loss of consciousness (fainting)

51. COMPLICATION..
 Infection.
 Heart-pumping problems.
 Heart failure.
 Irregular heartbeat (arrhythmia).

52. DIAGNOSTIC EVALUATION..
 ECHO/ ECG
 Other imaging tests. MRI and CT scans are
sometimes used to confirm the diagnosis of
pulmonary valve stenosis.
 Cardiac catheterization.

53. TREATMENT…
 Balloon valvuloplasty. Using the small tube that was
threaded through a vein in your leg to your heart for a
cardiac catheterization, your doctor places an
uninflated balloon through the opening of the
narrowed pulmonary valve. He or she then inflates the
balloon, widening the narrowed valve to increase
blood flow, and then removes the balloon.
 Open-heart surgery. When a balloon valvuloplasty
isn't an option, you may require open-heart surgery.
During surgery, your doctor either repairs the
pulmonary artery or valve or replaces the valve with
an artificial valve. Repairs to other congenital heart
defects can be made during the surgery, as well.
There's a slight risk of bleeding, infection or blood
clots associated with the surgery.

54. INTRODUCTION..
 Pulmonary regurgitation (PR, also called
pulmonic regurgitation) is a leaky pulmonary
valve. This valve helps control the flow of
blood passing from the heart to the lungs. A
leaky pulmonary valve allows blood to flow
back into the heart chamber before it gets to
the lungs for oxygen.

55. CAUSES..
 The most common causes for a leaky
pulmonary valve is pulmonary hypertension or
a congenital heart defect
 Less common causes are:
 Infective endocarditis
 Complications after surgery to repair tetralogy
of Fallot
 Carcinoid syndrome
 Rheumatic fever

56. SYMPTOMS..
 With this particular valve condition, there are
usually no early symptoms that would be
noticed by the patient.
 Rarely, these conditions can progress to heart
failure which can create more
noticeable symptomssuch as chest pain or
discomfort, fatigue, lightheadedness or
fainting.

57. TREATMENT..
 VALVE REPLACEMENT…