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Valvular Heart Disease. Valvular Heart Disease. Normal heart valves function to maintain the direction of blood flow through the atria and ventricles to the rest of the body Heart valves operate by passively opening and closing in response to pressure changes in the heart

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Valvular heart disease1
Valvular Heart Disease

  • Normal heart valves function to maintain the direction of blood flow through the atria and ventricles to the rest of the body

  • Heart valves operate by passively opening and closing in response to pressure changes in the heart

  • Valvular disease occurs when the valves are compromised and don’t open and close properly


Valvular disease
Valvular Disease

  • Two valvular problems:

    • Stenosis: thickening of the valve tissue  narrowing

    • Insufficiency: valve unable to close completely

  • Valvular heart disorders include:

    • Mitral stenosis, Mitral insufficiency

    • Aortic stenosis, Aortic insufficiency

    • Tricuspid stenosis, Tricuspid insufficiency

    • Pulmonary stenosis, pulmonary insufficiency


Mitral stenosis
Mitral Stenosis

  • Obstructs blood flow from LA to LV

  • Leads to:

    • Pulmonary HTN

    • RV hypertrophy

    • Right sided heart failure

    • Low cardiac output from inadequate filling of LV

  • May be caused by congenital abnormality or Rheumatic Fever


Mitral regurgitation mitral insufficiency
Mitral Regurgitation(Mitral Insufficiency)

  • Abnormality of leaflets, annulus, chordae tendinae, papillary muscles, or LV (hypertrophic CM)

  • Blood from LV flows back into the LA during systole

    • LA dilation and LV hypertrophy

    • Left sided heart failure


Mitral regurgitation mitral insufficiency1
Mitral Regurgitation(Mitral Insufficiency)

  • May be caused by:

    • Rheumatic fever

    • Mitral Valve prolapse

    • MI with ruptured chordaetendinae

    • LV failure

    • Marfan Syndrome


Mitral valve prolapse
Mitral Valve Prolapse

  • Congenital

  • Cusps of Mitral Valve are enlarged, thickened and

  • Cusps of valve  prolapse into LA during systole causing a “click” sound

  • Benign unless MV regurgitation develops


Aortic stenosis
Aortic Stenosis

  • Narrowed valve opening obstructs blood flow from LV to Aorta

  • LV pressure increases to overcome resistance

    • Increases workload

    • Left sided heart failure

    • Poor coronary artery perfusion


Aortic stenosis1
Aortic Stenosis

  • May be caused by:

    • Congenital (Bicuspid AV)

    • Rheumatic Fever

    • Atherosclerosis


Aortic regurgitation aortic insufficiency
Aortic Regurgitation(Aortic Insufficiency)

  • Blood flows back into the LV during diastole

    • Fluid overload in the LV

    • LV dilation and hypertrophy

  • Will eventually lead to Left sided heart failure


Aortic regurgitation aortic insufficiency1
Aortic Regurgitation(Aortic Insufficiency)

  • May be caused by:

    • Rheumatic Fever

    • Syphilis

    • HTN

    • Endocarditis

    • Marfan Syndrome


Pulmonic stenosis
Pulmonic Stenosis

  • Obstructs RV outflow causing RV hypertrophy and Right sided heart failure

  • May be a congenital abnormality or rarely caused by Rheumatic fever


Diagnostic tests
Diagnostic Tests

  • Cardiac Catheterization

  • EKG

  • Echocardiogram

    • Transthoracic and Transesophogeal


Medical treatment of valvular disorder
Medical Treatment of Valvular Disorder

  • Treat heart failure

    • Sodium restriction, diuretics, digoxin

  • Reduce risk factors

  • Repair or replace valve


Surgical treatment of valvular disorders
Surgical Treatment of Valvular Disorders

  • Open Heart Surgery

    • Valve Replacement- mechanical or tissue

    • Commissurotomy- repair (splitting of the fused mitral valve leaflet for treating stenosis

  • Valvuloplasty – surgical reconstruction of deformed cardiac valve

    • Percutaneous

    • Balloon reshapes and opens valve


Nursing interventions
Nursing Interventions

  • Goals:

    • Assist with ADLs

    • Symptomatic relief

    • Promote Comfort

    • VS, I&O, Auscultation lungs/heart; capillary perfusion checks, diet compliance, O2 tx


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