Chapter 23

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Chapter 23
2014-01-13 17:41:36
med surg

med surg
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  1. Valvular damage may result from ?
    congenital defects, rheumatic fever, or infections
  2. Cardiac Valvular Disorders
    The valves of the left side of the heart are most commonly affected. Forward blood flow can be hindered if the valve is narrowed, or stenosed, and does not open completely.
  3. Rheumatic fever?
    occurs as an autoimmune reaction to an upper respiratory (sore throat) group A beta-hemolytic streptococci infection. Two to 3 weeks after the streptococcal infection, rheumatic fever occurs.
  4. Signs and symptoms of Rheumatic fever.
    polyarthritis, subcutaneous nodules, chorea (brief, rapid, uncontrolled movements), carditis, fever, arthralgia, and pneumonitis.
  5. Mitral Valve Prolapse
    During ventricular systole, when pressure in the left ventricle rises, the flaps of the mitral valve normally remain closed and stay within the atrioventricular junction. In MVP on or both flaps bulge backward into the left atrium.

    MVP can be a hereditary collagen tissue disorder, although the cause is unknown. MVP is the most common form of valvular heart disease.

    MVP severity ranges from having a murmur to chordae tendineae rupture with mitral regurgitation.

    A murmur is the first diagnostic step. A normal ECG is usually seen with MVP, although inverted (downward) T waves (indicating ischemia) may be seen.

    A healthy lifestyle, including a good diet, exercise, stress management, and avoidance of stimulants and caffeine, can be important to prevent symptoms.
  6. Mitral Stenosis
    Mitral Stenosis results from thickening of the mitral valve flaps and shortening of the chordae tendineae, causing narrowing of the mitral valve opening.

    • The major cause is Rheumatic fever . Less common causes include congenital defects of the mitral valve, tumors, rheumatoid arthritis, systemic lupus.
    • A click or low pitched murmur may be heard. The murmur is a rumbling sound over the apex during diastole and is more pronounced right before systole. Pulmonary symptoms are most commonly seen. -- Exertional dyspnea (with activity), cough, hemoptysis (bloody sputum), and respiratory infections are the major symptoms.

    • Mitral stenosis is diagnosed with data from the patient history and physical examination and findings from diagnostic tests. Atrial flutter or fibrillation may be seen. A chest x-ray examination confirms enlargement of the affected heart chambers.