Module 5:
Nursing Management: Patients with Structural Inflammatory and Infectious Cardiac Disorders
Valvular Disease
4 Valves
o Right side is the Tricuspid and Pulmonic
o Left side is Mitral and Aortic
Acquired valvular diseases
o These are chronic and progress slowly
Heart valves do not open or close properly
Blood flow is affected
Stenosis: opening of the valve is narrowed and blood flow through the valve is reduced
o Results in pressure problem
Regurgitation: valves do not close completely and blood flows backwards through the
valve
o Results in blood volume problem
Mitral Stenosis
Mitral valve orifice is narrowed and blood flow from the left atrium to the left ventricle is
impaired or decreased
Major risk factor is rheumatic fever
Symptoms
o Decreased cardiac output
o Dyspnea on exertion (DOE)
o Paroxysmal nocturnal dyspnea (PND)
Wake up at night due to difficult breathing
o Chest pain and palpitation
o Atrial fibrillation
High possibility of alteration of the heart’s conduction system of the atrium
Diagnosed by echocardiogram
Treatment: focus on controlling the symptoms
Percutaneous mitral balloon valvuloplasty or mitral valve replacement may be indicated
Mitral Valve Disorders
, Mitral valve prolapse (MVP): Portion of one or both mitral valve leaflets (the two flaps) bulge
back into the left atrium during systole
o Usually asymptomatic
Mitral regurgitation (MR): Backward flow of blood from the left ventricle to the left atrium
during systole
o Common in elderly due to aging due to weakness of valve to close appropriately
o Results in decreased cardiac output
o Acute emergency situation
Rupture of capillary muscle of the mitral valve
Presents severe hemodynamic instability
Severe decreased of blood pressure
Increased shortness of breath
o Symptoms include
Fatigue, weakness
Tachycardia, orthopnea
Dyspnea on exertion, paroxysmal nocturnal dyspnea
o Treatments
Medications
Annuloplasty: procedure that tightens, reshapes or reinforces the ring
around the damaged valve
Valve leaflet repair
Chordoplasty
Nursing Management: Patients with Structural Inflammatory and Infectious Cardiac Disorders
Valvular Disease
4 Valves
o Right side is the Tricuspid and Pulmonic
o Left side is Mitral and Aortic
Acquired valvular diseases
o These are chronic and progress slowly
Heart valves do not open or close properly
Blood flow is affected
Stenosis: opening of the valve is narrowed and blood flow through the valve is reduced
o Results in pressure problem
Regurgitation: valves do not close completely and blood flows backwards through the
valve
o Results in blood volume problem
Mitral Stenosis
Mitral valve orifice is narrowed and blood flow from the left atrium to the left ventricle is
impaired or decreased
Major risk factor is rheumatic fever
Symptoms
o Decreased cardiac output
o Dyspnea on exertion (DOE)
o Paroxysmal nocturnal dyspnea (PND)
Wake up at night due to difficult breathing
o Chest pain and palpitation
o Atrial fibrillation
High possibility of alteration of the heart’s conduction system of the atrium
Diagnosed by echocardiogram
Treatment: focus on controlling the symptoms
Percutaneous mitral balloon valvuloplasty or mitral valve replacement may be indicated
Mitral Valve Disorders
, Mitral valve prolapse (MVP): Portion of one or both mitral valve leaflets (the two flaps) bulge
back into the left atrium during systole
o Usually asymptomatic
Mitral regurgitation (MR): Backward flow of blood from the left ventricle to the left atrium
during systole
o Common in elderly due to aging due to weakness of valve to close appropriately
o Results in decreased cardiac output
o Acute emergency situation
Rupture of capillary muscle of the mitral valve
Presents severe hemodynamic instability
Severe decreased of blood pressure
Increased shortness of breath
o Symptoms include
Fatigue, weakness
Tachycardia, orthopnea
Dyspnea on exertion, paroxysmal nocturnal dyspnea
o Treatments
Medications
Annuloplasty: procedure that tightens, reshapes or reinforces the ring
around the damaged valve
Valve leaflet repair
Chordoplasty
