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![• 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](https://image.slidesharecdn.com/mitralandaorticvalvesfinal-230705224631-003cd8c7/85/Mitral-and-Aortic-Valves-Final-pptx-58-320.jpg)
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Mitral and Aortic Valves Final .pptx
- 1. SCHOOL OF NURSING DEPARTMENTOF 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 iketo.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 • MitralValve Prolaps • Mitral Valve Regurgitation • Mitral Valve Stenosis • AorticValve regurgitation • Aortic Valve Stenosis • Nursing Mngement of Valvular heart disese.
- 4.
- 5. Heart Chambers andValves 2
- 6. Overview • The mitralvalve 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, thepapillary 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 • Menolder than 50 years old • HTN • Graves' disease. • Marfan syndrome. • Muscular dystrophy. • Scoliosis. • • 8
- 12. Complications • Mitral Valveregurgitaion . • Heart rhythm problems (arrhythmias). 9
- 13.
- 14. Mitral Valve ProlapseECG Finding • inversion of T wave • Enlarged LA • Atrial Fibrilation 11
- 15.
- 16. Mitral Valve Echofinding • To confirm mitral valve prolapse and severity • Thickend leaflets greater than 5mm. • Leaflet displacement >2mm 13
- 17. Mitral Valve Prolapsetreatment • Exercise • Pain relievers • Relaxation and stress reduction techniques • Avoidance of caffeine and other stimulants • Beta-blockers • • 14
- 18. Follow-Up of MitralValve 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. 15
- 19.
- 20. Overview • MR isa 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 mitralvalve 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. • • 18
- 22. Causes • Mitral.Degenaration • Mitralprolaps • Rheumatic valvular disease • Endocarditis • Congenital mitral regurgitation • Rupture of Chordate tendane • Rupture os Papillary muscle • Dialated cardiomayopathy • Ischemic heart disease 19
- 23. Symptoms • Fatigue • heartmurmur • Irregular heartbeat (arrhythmia) • (dyspnea) (Orthopnea) • (palpitations) • edema 20
- 24. Risk factors • Infectionsthat 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 andoften rapid heart rate (atrial fibrillation). • High blood pressure in the lungs (pulmonary hypertension). • CHF 22
- 26. ECG and EchoFindings • 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 ofMitral redurgitation • blood flowing from LV to LA during systol • Detect dialated left atrium and ventricle 24
- 28. Staging Heart valve diseaseis 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. 25
- 29.
- 30. Defnition • Narrowing ofthe 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 ofbreath, 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 29
- 33. Risk factors • Untreatedstrep infections • Aging • Radiation Therapy 30
- 34. Complications • Irregulr heartbeat • Blood clot • High blood pressure in the lung arteries • Right side heart failure 31
- 35. ECG findings • Thereis 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.
- 37. Echo Finding • Reducedmitral 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 prophylaxisfor 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 35
- 39.
- 40. Defnition • a conditionthat 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 ofbreath 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 aorticvalve 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 • Olderage • 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 • feelinglightheaded • Heart failure • Heart rhythm problems (arrhythmias) • Death 41
- 45. ECG finding • LeftVentricular hypertrophic • T wave inversion 42
- 46.
- 47. Treatment • Antibiotics • Aorticvalve repair • Aortic valve replacement • BP lowering medications • Anticuagulant • Blood thiner 44
- 48.
- 49. Defnition • Narrowing ofthe Aortic valve resulting in Obstruction of blood flow from the left ventricle to aorta during systole. 46
- 50. Symptoms Symptoms of aorticvalve 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 • Calciumbuildup on the valve (aortic valve calcification) • Fibrosis • Rheumatic fever • Congenital Bicusped aortic valve • Degerarative disease 48
- 52. Risk factors Risk factorsof 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 49
- 53. Complications Aortic valve stenosiscan 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.
- 56. • Aortic valvewith 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 heartDiseases 54
- 58. • Assess mentalstatus (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 skincolor 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 O2as 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). 57
- 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 58
- 62.
- 63.