Topic : Vulvular Heart Disease
Prepared by
Sushama Biswas
Roll : 04
B.Sc. in Post Basic Nursing
Session : 2020 – 2021
Khulna Nursing Collage, Khulna
Valvular Heart Disease
Heart valves are the parts of heart that acts like doors.
Definition of valvular disease:
Valvular disease or Valvular heart disease in a cardiovascular disease occurs
when the any valve in the heart has damaged or is diseased. It occurs when heart
valve do not work correctly. It may be caused may congenital defect in one or
more heart valve.
Types of valvular disease:
The main valve condition that disrupt the flow of blood in the heart, which
includes
A. Valvular stenosis:
The stiffening or thickening of the valve that keeps the valve from
opening all the way and limit blood flow. The valvular stenosis includes:
1. Aortic valve stenosia
2. Mitral valve stenosis
3. Tricuspid valve stenosis
4. Pulmonary valve stenosis.
B. Valvular regurgitation:
A leaky / leaking valve that does close completely. As a result blood goes back
into a chamber instead of forward. The valvular regurgitation includes:.
1. Aortic regurgitation/ insufficiency
2. Mitral regurgitation/insufficiency
3. Tricuspid regurgitation/insufficiency
4. Pulmonary regurgitation/ insufficiency
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C. Valvular prolapsed:
Prolapse is a condition when the valve flaps (leaflets) step out of place or form a
bulge. This can lead to improper on uneven closure of the heart valve that
backward through the valve and flow may text leak one way blood disrupted.
The valvalarp prolapse includes
1. Mitral valve prolapse (most common)
2. Tricuspid valve prolapse
3. Pulmonary valve prolapse
4. Aortic valve prolapsed (Less common)
* Most common valvular disease in adults are
Aortic stenosis.
Aortic regurgitation
Mitral Stenosin
Mitral regurgitation.
Causes:
Congenital valve disease (Being born with it)
Bicuspid aortic valve disease.
Acquired valve disease (infective endocarditis, Rheumatic fever,
Rheumatic)
High blood cholesterol
Hypertension
Aortic aneurysm
Auto immune disease (Lupus)
Connective tissue diseases. Rheumatic Carditis.
Traumatic valve receptor
Coronary artery disease
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Cardiomyopathy
Heart attack, Heart dilatation. Tumors (less common)
Some types of drugs & radiation.
Risk factor
Older age,
Sex (male gender are at risk)
Positive family history
History of certain infection that can affect
History of certain form of heart disease
the heart.
Hypertension
High cholesterol
Diabetes mellitus.
Smoking
Obesity
Congenital heart disease
Pathophysiology:
Regurgitation mitral orifice.
Volume overload on the 2V
LV dilatation
LV is decompressed into LA curing diastole.
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Backward flow of blood in the LA
volume overload in LA
LA enlargement.
Raised left atrium pressure
Raised pressure in pulmonary vasculature
Pulmonary oedema.
Clinical feature:
Chest pain on chest tightness.
Shortness of breath.
Dyspnoea
Breathlessness Palpitation
Irregular heartbeat
Lightheadedness on Dizziness and heavy coughing Wheezing and
Difficulty in catching breath.
Fever chill or 2 body aches (in case of infection causing heart valve
disease)
Difficulty in normal activity
Difficulty sleeping
Rapid weight gain.
Swollen ankles, feet on abdomen.
Fatigue
Weakness
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Investigation
ECG
Echocardiography (Doppler)
Chest x-ray
Cardiovascular Magnetic Resonance Imaging (CMRI)
Stress echo on exercise test.
Cardiac catheterization (Angiogram)
Radionuclide scans.
Medical management:
Management depends on the severity, it problem is minor may not need urgent
treatment, required regular checkup. But in case of serious condition required
intensive treatment management includes
1. Medication: Medication heart disease but it are not cure valuutar may relieve
symptoms like swelling, abnormal heart rhythm, high blood pressure etc.
Doctor may Prescribe medication like
Diuretics
Blood thinners.
Antiarrythmics
Vasodilatores
Beta Blockers
ACE inhibitors
Antibiotics.
2. Surgeries and other Procedures -
a. Heart valve. Surgery to Repair or replace heart valve that helps to prevent
lasting damage in the heart.
b. Valve repair
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=> Heart valve repair by Patching holes tears, separating valve leaflets,
reshaping holes the valve.
⇒ valvuloplasty (inserting a then catheter with a ballon)
Annuloplasty (a ring of fibrous issue at the base of the heart valve)
c. Valve replacement - If a valve fatty heart cannot be repaired, it in removes
and replaced with a mechanical or biological valve.
d. Transcatheter Aortic valve implantation(TAVI)
3. Lifestyle change: Maintain a healthy lifestyle by
Be smoke free.
Be more active.
Maintain healthy weight
Eat a healthy balanced diet
Avoid alcohol
Manage stress
Maintain normal sleeping pattern.
Nursing management:
1. Provide complete bed rest
2. Keep the patient in comfortable position with proper ventilation.
3. In ease of breathing difficulty kept the Patient in semi fowler's position.
4. Assess the general condition of the Patient
5. Monitor vital sign routinely the chart and recorded on the chart
6. Monitor intake output, recorded on the chair
7. Assess the symptoms of fluid over lead frequently.
8. Monitor oxygen saturation level
9. Administer 02 if needed.
10.Monitor ECG of the patient and the doctor for any changes inform
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1. 11- Advice to adopt a healthy eating pattern such as avoiding caffeine,
smoking etc.
11.Advice Patient to maintain physical and emotional rest
12.In case of oedema advise to restrict intake of fluid and sodium.
13.Encourage the patient to perform self care activities.
14.Monitor sleep pattern if sleep disturbance present, administer a sedative
according to doctors advice
15.Encourage patient to engage in recreational activities.
16.Instruct the patient to take over the Counter drug with caution
17.Reassure the patient and his/her family members
18.Inform the patient to take about his/her disease condition and the
treatment procedure and side effects.
19.Encourage patient to take medicine properly and routinely.
20.Ensure all medication according to doctor's advice.
Complication
1. Heard failure
2. Blood clots.
3. Atrial fibrilation.
4. Heart rhythm abnormalities.
5. Systemic embolism.
6. Arrythmias.
7. Ascites and pleural effusion.
8. Stroke on other rural disease
9. Sudden death.
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Prevention:
Stop smoking, alcohol, caffeine intake.
Eat a healthy balanced diet (low fat, salt) Regular exercise and control
weight
Maintain careful control of blood sugar.
Being Physically more active
Continue take medicine for high blood Pressure or high cholesterol.
Taking proper treatment infection control. quickly for
Prevent infective endocarditis
Get regular health checkup
Maintain a routine for diet, exercise, rest, sleep etc.
Take good care of teeth & gums.
