Valvular Heart Disease Cardiomyopathy and Aneursyms. by Laurie Dickson. Valvular Heart Disease. Heart contains Two atrioventricular valves Mitral Tricuspid Two semilunar valves Aortic Pulmonic Valvular Disease. Valvular Heart Disease. Types of valvular heart disease depend on
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by Laurie Dickson
Aortic Valve Problems
Nitroglycerin is contraindicated because it reduces preload
Congenital Heart Defect
Most Common Congenital Heart Disease
YouTube - Corrigan's sign
This is a mechanical valve prosthesis of the more modern tilting disk variety (for the mitral valve). Such mechanical prostheses will last indefinitely from a structural standpoint, but the patient requires continuing anticoagulation because of the exposed non-biologic surfaces.
This is an excised porcine bioprosthesis. The main advantage of a bioprosthesis is the lack of need for continued anticoagulation. The drawback of this type of prosthetic heart valve is the limited lifespan, on average from 10 to 15 years (but sometimes shorter) because of wear and calcification.
MitraClip 3D Animation
This very large heart has a circular shape because all of the chambers are dilated. It felt very flabby, and the myocardium was poorly contractile. This is an example of a cardiomyopathy.
There is marked left ventricular hypertrophy, with asymmetric bulging of a very large interventricular septum into the left ventricular chamber. This is hypertrophic cardiomyopathy. About half of these cases are genetic. Both children and adults can be affected, and sudden death can occur.
Treatment Goal- improve ventricular filling and relieve LV outflow obstruction
Echo-wall motion and EF
No specific Treatment- goal to improve diastolic filling
HF and dysrhythmias
avoid strenuous activity, dehydration, increases in SVR
high risk for IE
Ms. C. 81y/o admitted to CCU with SOB. She has a hx of mitral valve regurgitation with left ventricular enlargement. She received 100mg lasix IV in ER and her dyspnea improved. She has O2 at 3L/min. She has crackles bibasilar and monitor is SR rate 94-96 with occ. PVC’s. The only med ordered is MSO4 2-4mg IV as needed for chest pain or dyspnea.
As you go to assess her you find her in bed at 60 degree angle. She is pale, has circumoral cyanosis and respirations are rapid and labored.
What action should you take first?
Fusiform-Circumferential, relatively uniform in shape
Saccular-Pouchlike with narrow neck connecting bulge to one side of arterial wall
Fusiform-most are fusiform and 98% are below the renal artery
Abdominal aortic aneurysms
Dissecting aneurysms are unique and life threatening. A break or tear in the tunica intima and media allows blood to invade or dissect the layers of the vessel wall. The blood is usually contained by the adventitia, forming a saccular or longitudinal aneurysm.
Aortic dissection occurs when blood enters the wall of aorta, separating its layers, and creating a blood filled cavity.
Acute Intervention- Post-op ICU monitoring