Nursing 211

N211: Health Differences Across the Lifespan I of 148 Valvular heart disease is the mechanical disruption of blood flow through the heart. The heart valves are unable to open fully (stenosis) or close fully (regurgitation or insufficiency). Valve dysfunction most commonly occurs on the left side of the heart. The mitral valve is the most commonly involved, followed by the aortic valve. Common causes of valvular disease are rheumatic fever, congenital heart disease, syphilis, endocarditis and hypertension. Prevention of rheumatic heart disease would reduce the incidence of valvular heart disease. 1.14 Aortic Insufficiency Aortic insufficiency results in blood flowing back into the left ventricle during diastole (rest), creating fluid overload in the left atrium and pulmonary system. The causes include endocarditis, hypertension, rheumatic fever, and syphilis. Diagnosis is made with echocardiography which will show left ventricular enlargement, x-ray shows left ventricular enlargement and pulmonary vein congestion. 1.15 Mitral Insufficiency Mitral insufficiency results in blood flowing back into the left atrium during systole (squeeze), the atrium enlarges and the ventricle dilates to accommodate the increased volume of blood. The causes include left ventricular failure, mitral valve prolapse, and rheumatic fever. Diagnosis is made by cardiac catheterization which shows mitral regurgitation and elevated atrial and pulmonary artery wedge pressures. X-ray shows left atrial and ventricular enlargement. 1.16 Mitral Stenosis Mitral stenosis obstructs blood flow from the left atrium to the left ventricle. This can be caused by rheumatic fever. Diagnosis is with cardiac catheterization that shows diastolic pressure gradient across the valve and elevated left atrial and pulmonary artery wedge pressures. Echocardiography shows thickened mitral valve leaflets. ECG shows left atrial hypertrophy and x-ray shows left atrial and ventricular enlargement. 1.17 Mitral Valve Prolapse ©2012 Achieve Page 33