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Valve disorders
regurgitation, stenosis and valve prolapse (stretched and blood will go back)
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Mitral stenosis
most common cause is rheumatic fever
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Mitral stenosis causes
valve thickening by fibrosis and calcification
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In mitral stenosis
valve leaflets fuse and openings narrow; atrial pressure rises, left atrium dilates, pulmonary artery pressure increases and right ventricle hypertrophies
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What happens first then second in mitral stenosis
pulmonary congestion and RT HF happen first; then when LT VEN receives insufficient blood volume, preload is decreased and CO falls
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Mitral regurgitation
mitral valve doesnt close tightly; insufficient blood to rest of the body
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Primary cause of mitral regurgitation
degenerative due to aging and ineffective endocarditis
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Mitral valve prolapse
doesnt close properly and bulges; familial tendency; dizziness, syncole and palpitations
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Aortic stenosis
aortic valve; disease of wear and tear
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Nonsurgical mgmt.
rest, drugs like beta blockers, dig, O2, nitrates, vasodilators, anticoagulants
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Surgical mgmt.
reparative procedures, balloon valvuloplasty, direct or open commissurotomy, mitral valve annuloplasty, replacement
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Balloon valvuloplasty
rarely lasts more than 6 months
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After valvuloplasty,
observe for bleeding, assess for signs of a regurgitant valve, CO, and heart rhythm, emboli
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Valve replacement
diseased mitral valve is removed and replaced
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Types of replacement valves
mechanical (dont deteriorate but need lifetime anticoagulant therapy) or biologic valves
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Before valve replacement
teach how to cough, pain, preop dental exam
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Cardiomyopathy
subacute or chronic disease of cardiac muscle
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Dilated cardiomyopathy
extensive damage to the myofibrils and interference with myocardial metabolism; both ventricles are dilated, systolic function is impaired
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Causes of dilated cardiomyopathy
booze, chemo, infection, inflammation, poor nutrition
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Pt symptoms of dilated cardiomyopathy
decreased CO causes dyspnea on exertion, no exercise, fatigue and palpitations
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Hypertrophic cardiomyopathy
abnormally thick fibers; athletes
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Restrictive cardiomyopathy
walls are rigid; stiff ventricles that restrict filling during diastole
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Arrhythmogenic cardiomyopathy
genetic defects of parts of the heart, affects young adults, results from replacement of myocardial tissue with fibrous and fatty tissue
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Dilated cardiomyopathy
increased atrial and ventricular chamber size, decreased muscle size
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Hypertrophic cardiomyopathy
thickened interventricular septum, decreased ventricular size, left ventricular hypertrophy
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Restrictive cardiomyopathy
left ventricular hypertrophy
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