Ch.34 Valvular Heart Disease

What is valvular heart disease?

Valve dysfunction

Which heart valves are located on the left side of the heart?

Mitral and aortic

Which valve disorder is most commonly associated with IV drug use?

Tricuspid dysfunction

What effect does valvular disease have on stroke volume?

Decreases stroke volume

What cardiac change can occur over time with valvular disease?

Hypertrophy

What major complication can result from valvular disease?

Heart failure

What age-related change commonly affects the mitral and aortic valves?

Fibrotic thickening

What dietary restriction helps prevent heart failure in valvular disease?

Low sodium diet

What type of valve dysfunction involves a narrowed opening?

Stenosis

What type of valve dysfunction involves backward blood flow?

Insufficiency

What is another term for insufficiency?

Regurgitation

What are the two major categories of valvular heart disease?

Congenital and acquired

What is the most common cause of valvular disease in developed countries?

Degenerative disease

What is the most common cause of valvular disease in developing countries?

Rheumatic disease

What infection commonly causes rheumatic valvular disease?

Streptococcal infection

What cardiovascular condition is a risk factor for valvular disease?

Hypertension

What childhood illness increases risk for mitral valve disease?

Rheumatic fever

What infection increases risk for valvular heart disease?

Endocarditis

What genetic connective tissue disorder increases risk for valvular disease?

Marfan syndrome

What are the most common causes of valvular disease in older adults?

Calcification and atherosclerosis

What physical assessment finding is common in valvular heart disease?

Murmur

What grading scale is used for heart murmurs?

I to VI

What type of valve damage commonly causes pulmonary hypertension?

Left-sided valve damage

What respiratory symptom is common with left-sided valve disease?

Orthopnea

What nighttime breathing difficulty is common with left-sided valve disease?

PND

What symptom results from decreased cardiac output in valvular disease?

Fatigue

What diagnostic test identifies chamber enlargement and pulmonary congestion?

Chest x-ray

What diagnostic test identifies chamber hypertrophy?

ECG

What diagnostic test evaluates valve function and regurgitation?

Echocardiogram

What diagnostic procedure provides detailed views of the mitral and aortic valves?

TEE

What test evaluates cardiac function during exercise?

Stress echocardiography

What study determines ejection fraction during activity and rest?

Radionuclide study

What diagnostic procedure evaluates coronary artery disease in valvular clients?

Angiography

What daily assessment helps monitor for heart failure?

Daily weight

What fluid restriction may be necessary in valvular disease?

Fluid restriction

What type of murmur is associated with mitral stenosis?

Apical diastolic murmur

What dysrhythmia is commonly associated with mitral stenosis?

Atrial fibrillation

What respiratory symptom is common with mitral stenosis?

Dyspnea on exertion

What respiratory symptom may occur with mitral stenosis?

Hemoptysis

What type of cough is common with mitral stenosis?

Dry cough

What type of murmur is associated with mitral insufficiency?

Systolic murmur at apex

What extra heart sound is associated with mitral insufficiency?

S3

What neck finding may occur with mitral insufficiency?

JVD

What liver finding may occur with mitral insufficiency?

Hepatomegaly

What type of murmur is associated with aortic stenosis?

Systolic murmur

What extra heart sound is associated with aortic stenosis?

S4

What chest symptom commonly occurs with aortic stenosis?

Angina

What exertional symptom is common with aortic stenosis?

Syncope

What pulse pressure change occurs with aortic stenosis?

Narrowed pulse pressure

What type of murmur is associated with aortic insufficiency?

Diastolic murmur

What pulse pressure change occurs with aortic insufficiency?

Widened pulse pressure

What pulse finding is associated with aortic insufficiency?

Bounding pulse

What rhythm change is associated with aortic insufficiency?

Sinus tachycardia

What nighttime symptom is associated with aortic insufficiency?

Nocturnal angina

What blood pressure finding occurs with aortic insufficiency?

Elevated systolic pressure

What medication class removes excess fluid in heart failure?

Diuretics

What loop diuretic is commonly used in valvular disease?

Furosemide

What thiazide diuretic is commonly used in valvular disease?

Hydrochlorothiazide

What potassium-sparing diuretic is commonly used in valvular disease?

Spironolactone

What electrolyte imbalance can occur with loop diuretics?

Hypokalemia

What electrolyte imbalance can occur with thiazide diuretics?

Hypokalemia

What foods help prevent hypokalemia?

Potassium-rich foods

What medication class reduces afterload?

ACE inhibitors

What medication class blocks angiotensin receptors?

ARBs

What medication class slows heart rate and decreases workload?

Beta-blockers

What medication class relaxes vascular smooth muscle?

Calcium channel blockers

What vasodilator is commonly used to reduce afterload?

Hydralazine

What adverse effect can occur with the first dose of an ACE inhibitor?

Hypotension

What medication improves cardiac contractility?

Digoxin

How long should a pulse be counted before taking digoxin?

One minute

At what pulse rate is digoxin commonly held?

Less than 60 bpm

What medication type should not be taken with digoxin?

Antacids

How long should digoxin and antacids be separated?

Two hours

What visual symptom may indicate digoxin toxicity?

Visual changes

What neurological symptom may indicate digoxin toxicity?

Confusion

What appetite change may indicate digoxin toxicity?

Loss of appetite

Why are anticoagulants prescribed after mechanical valve replacement?

Prevent thrombus

What laboratory values are monitored with anticoagulant therapy?

PT and INR

What neurological complication should be monitored for in anticoagulated clients?

Stroke

What procedure uses a balloon to open a stenotic valve?

Balloon valvuloplasty

Through what artery is a valvuloplasty catheter commonly inserted?

Femoral artery

What type of valve replacement requires lifelong anticoagulation?

Mechanical valve

How often do tissue valves typically require replacement?

Every 7-10 years

What postoperative complication should be monitored for after valvuloplasty?

Bleeding

What embolic complication should be monitored for after valve procedures?

Emboli

What surgical procedure relieves valve stenosis by opening fused leaflets?

Commissurotomy

What procedure narrows a dilated valve annulus?

Annuloplasty

What surgery reconstructs damaged valve support structures?

Chordae reconstruction

What specialty should be consulted for cardiac management?

Cardiology

What specialty can assist with dietary restrictions?

Nutritional services

What specialty can help with prolonged weakness and mobility issues?

Rehabilitation

Why are prophylactic antibiotics needed before dental procedures?

Prevent endocarditis

What hygiene practice helps prevent endocarditis?

Oral hygiene

What daily weight gain should be reported within one day?

1-2 pounds

What weekly weight gain should be reported within one week?

3 pounds

What substances should clients with valvular disease avoid?

Caffeine and alcohol

What over-the-counter ingredients should be avoided due to dysrhythmia risk?

Ephedrine and epinephrine

What skin finding may indicate endocarditis?

Petechial rash

What symptom should be reported immediately because it may indicate infection?

Fever

What major complication results from ineffective heart valves?

Heart failure