Objective 15 and 16.txt

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Objective 15 and 16.txt
2013-09-02 14:26:24
Objective 15 16

Objective 15 and 16
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  1. Valve disorders
    regurgitation, stenosis and valve prolapse (stretched and blood will go back)
  2. Mitral stenosis
    most common cause is rheumatic fever
  3. Mitral stenosis causes
    valve thickening by fibrosis and calcification
  4. In mitral stenosis
    valve leaflets fuse and openings narrow; atrial pressure rises, left atrium dilates, pulmonary artery pressure increases and right ventricle hypertrophies
  5. 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
  6. Mitral regurgitation
    mitral valve doesn’t close tightly; insufficient blood to rest of the body
  7. Primary cause of mitral regurgitation
    degenerative due to aging and ineffective endocarditis
  8. Mitral valve prolapse
    doesn’t close properly and bulges; familial tendency; dizziness, syncole and palpitations
  9. Aortic stenosis
    aortic valve; disease of wear and tear
  10. Nonsurgical mgmt.
    rest, drugs like beta blockers, dig, O2, nitrates, vasodilators, anticoagulants
  11. Surgical mgmt.
    reparative procedures, balloon valvuloplasty, direct or open commissurotomy, mitral valve annuloplasty, replacement
  12. Balloon valvuloplasty
    rarely lasts more than 6 months
  13. After valvuloplasty,
    observe for bleeding, assess for signs of a regurgitant valve, CO, and heart rhythm, emboli
  14. Valve replacement
    diseased mitral valve is removed and replaced
  15. Types of replacement valves
    mechanical (don’t deteriorate but need lifetime anticoagulant therapy) or biologic valves
  16. Before valve replacement
    teach how to cough, pain, preop dental exam
  17. Cardiomyopathy
    subacute or chronic disease of cardiac muscle
  18. Dilated cardiomyopathy
    extensive damage to the myofibrils and interference with myocardial metabolism; both ventricles are dilated, systolic function is impaired
  19. Causes of dilated cardiomyopathy
    booze, chemo, infection, inflammation, poor nutrition
  20. Pt symptoms of dilated cardiomyopathy
    decreased CO causes dyspnea on exertion, no exercise, fatigue and palpitations
  21. Hypertrophic cardiomyopathy
    abnormally thick fibers; athletes
  22. Restrictive cardiomyopathy
    walls are rigid; stiff ventricles that restrict filling during diastole
  23. Arrhythmogenic cardiomyopathy
    genetic defects of parts of the heart, affects young adults, results from replacement of myocardial tissue with fibrous and fatty tissue
  24. Dilated cardiomyopathy
    increased atrial and ventricular chamber size, decreased muscle size
  25. Hypertrophic cardiomyopathy
    thickened interventricular septum, decreased ventricular size, left ventricular hypertrophy
  26. Restrictive cardiomyopathy
    left ventricular hypertrophy