Mitral Valve
Stenosis
Mitral Valve
Regurgitation
Mitral Valve
Prolapse
Aortic Valve
Stenosis
Aortic Valve
Regurgitation
- Results from rheumatic
HD
- scarring of valve leaflets
and chordae tenineae
- contractures dvlp,
adhesions btwn
commissures of leaflets
- damaged caused by MI
(remodeling), chronic
rheumatic HD, mitral valve
prolapse, ischemic
papillary muscle
dysfunction, IE
- incomplete valve closure
- backward flw of bld
- acute = pul edema
- chronic = L atrial
enlargement, ven
hypertrophy→ ↓CO
- abnormality of leaflets
and papillary muscle or
chordae
- leaflets prolapse bck into
LA
- unknown cause – genetic
link
- DIAGNOSTIC: w/ echo
- DRUGS: beta blkrs
- TREATMENT: valvular
surgery
- congenital stenosis
discovered in childhood,
adolescence or yng
adulthood
- obstruction of flw from
LV to aorta
- can also be degenerative
or caused by RF
- LVH and ↑myocardial
O2 consumption
- ↓CO, pul HTN, HF
- significant mortality rate
if untreated
- EXERTIONAL DYSPNEA
- fatigue
- palpitations
- hoarseness
- chest pain
- Acute MR = thready
peripheral pulses and
cool, clammy extremities
- Chronic MR =
asymptomatic for yrs until
LV srts to fail/ THEN
weakness, gradual
progressive dyspnea,
orthopnea, peripheral
edema, murmur
- most pts asymptomatic
for life
- murmur d/t regurgitation
- dysrhythmias cause
palpitations, lightheadedness, dizziness
- IE, chest pain
unresponsiveness to
nitrates
- angina
- syncope
- exertional dyspnea
- normal to soft S1
- ↓ or absent S2
- systolic murmur
- PROMINENT S4
- Acute AR = caused from
IE, trauma or aortic
dissection, LIFE
THREATENING
EMERGENCY
- Chronic AR = rheumatic
HD, connective tissue
prob, syphilis
- backward flw from
ascending aorta into LV
- w/ chronic = LV dilation
and hypertrophy
- ↓ myocardial
contractility
- pul HTN and RV failure
- Acute AR = svre dyspnea,
chest pain, hypoTN,
cardiogenic shock
- Chronic AR =
asymptomatic for yrs,
exertional dyspnea,
orthopnea, PND, angina,
water-hammer pulses,
murmur
- antibiotic prophylaxis if
MR present
- avoid caffeine and OTC
stimulants
- no nicotine
- exercise
*KNOW pts medical hx
- POOR PROGNOSIS IF
SYMPTOMATIC AND NOT
CORRECTED
- use nitroglycerin
cautiously – CAN WORSEN
CHEST PAIN
Characteristics
Clinical
Manifestations
Patient
Education