Mitral Valve Regurgitation 993
 Primary cause is Rheumatic Hear Disease, but early and effective antibiotic
treatment can help decline MVR
 Keep an eye out on patient’s with Connective tissue disorders (Marfan’s
syndrome), Congentital valve malformation, CAD, endocarditis, dilated
cardiomyopathy, mitral valve prolapse, amyloidosis, ankylosing spongylitis,
and MI—these are other causes of MVR
Mitral Valve Stenosis 993
 Most frequent complaint is dyspnea
 Watch for symptoms that appear gradually over the course of a 20-30 year
period and typically begin late in the fifth decade of life
 Symptoms appear with exercise in early stages with rese in the later stages.
Mitral Valve Prolapse 994
 Provide emotional support because many patients experience panic attacks
and a feeling of intense anxiety and some feel an overwhelming sense of
impending doom
 Chest pain is said to be dull and can last for hours or days and not brought on
by exertion ( so educate patient)
Myocarditis 986
 Place patient on strict bed rest and allow minimal activity until the cause has
been identified and treatment instituted
Pancarditis 973
 Administer anti-inflammatory analgesic is essential and help patient find a
comfortable position such as sitting and leaning forward which gives more
room in the pleural cavity
 Warm heating bad or hot water bottle may help relieve pain
Pericardial friction rub 83
 When assessing patient, sound best heard over left sternal border in 2nd, 3rd,
4th intercoastal space with the diaphragm of stethoscope
 To distinguish it from pleural friction rub is to ask pt to hold breath
momentarily and if rubbing persist it is cardiac issue, not respiratory
Pericardial effusion
 Nurse can distringuish if heart sounds are muffled and hard to auscutate
Pericardial window 985
 Educate patient that this surgical removal of pericardium will relive the
compression on the heart and allow for adequate ventricular filling and
cardiac output
Pericardiectomy 985
 Educate patient that this surgical removal of pericardium will relive the
compression on the heart and allow for adequate ventricular filling and
cardiac output
Pulmonic regurgitation 997

Nurses should take notice of patient because dypnea and fatigue are clinical
manisfestations and Atrial fibrillation is common.
 Every effort is made to terminate dysrhythmia b/c it decreases cardiac
output: drug therapy can be used for conversion to normal sinus rhythm
(Calcium-channel blockers)
Pulmonic Stenosis 995
 Nurses should take notice of patient because dypnea and fatigue are clinical
manisfestations and Atrial fibrillation is common.
 Every effort is made to terminate dysrhythmia b/c it decreases cardiac
output: drug therapy can be used for conversion to normal sinus rhythm
(Calcium-channel blockers)
Pulsus Paradoxus 984
 Important diagnostic clue that nurses should recognize : a drop greater 10
mmHg when there is an increase in thoracic pressure as a result of
pericardial swelling
 Patients will become restless and decrease LOC as fluid accumulates
Restrictive Cardiomyopathy 1015
 Nurses should make sure patient does not do too much activity and get
plenty of rest to decrease workload of heart and conserve energy
Rheumatic Fever 973
 Nurses should stress the importance of prevention and early treatment of
streptococcal infection with antibiotics can prevent the development
(educate patients)
Rheumatic heart disease 973
 Nurses should obtain a complete hx and physical in order to evaluate the risk
factors and the extent of the disease process in suspected patients
Stress Echocardiography 1020
 Nurses should know how to read results correctly: development of a new
myocardial wall motion abnormality or failure of heart to increase strength
of contraction during the test is a positive indication of reversible ischemia
 Nurses should know that this can be an alternative for patients with known
coronary or valvular heart disease, and for those who often cannot exercise
to their peak heat rate and/or have baseline ECG abnormalities
Transesophageal Echocardiography 1020
Educate patient that this is minimally invasive and usually perfomed under
procedural sedation with slight risk of complication (trauma to structures of mouth
or throat)
Tricsupid Regurgitation 995
 Nurse should pay attention to murmurs being more intense with inspiration
when ascultating
 Nurses should be away that this usually results from pulmonary
hypertension
Tricuspid Stenosis 995
 Nurse should pay attention to murmurs being more intense with inspiration
when ascultating
 Nurse should be aware that right-sided heart failure can result
 TVS usually occurs with rheumatic heart disease, IV drug use, and
concurrently mitral stenosis
Vavular Regurgitation 992
 Provide emotional support because Heart failure is the eventual outcome
 Educate patients more about this to lessen stress
Valvular Stenosis 992
 Nurses should be aware that patients with mild to moderate stenosis are able
to maintain cardiac output at rest but becomes symptomatic with exercise as
heart isn’t able to respond to increase need for O2
Valvuloplasty 999
 Educate patients that they will be placed under general anesthesia and
repaired by cardiopulmonary bypass for repair of the valve leaflet.