Lipp Vis Nursing ChaptLWBK1630_C02_p013-068

38  Chapter 2 • Cardiovascular Care

Treatment Treatment depends on affected valve:

Affected Valve

Causes

PICTURING PATHO

Aortic stenosis

Bicuspid aortic valve (or other congenital valve anomaly) Aortic valve sclerosis

Aortic regurgitation

Dilation of the ascending aorta, usually related to hypertension and age

Thickened and stenotic valve leaflets

Retracted fibrosed valve leaflets

A

B

Disease of the aortic valve as viewed from the aorta. A. Stenosis of the valve opening. B. An incompetent valve that is unable to close completely. (Reprinted with permission from Porth C. Essentials of Pathophysiology . 4th ed. Philadelphia: Wolters Kluwer; 2015.)

Mitral stenosis

Rheumatic heart disease

Pulmonary veins Aortic valve

Left atrium

Mitral regurgitation

Myxomatous degeneration (mitral valve prolapse)

Mitral valve

Systole

Left ventricle

Tricuspid regurgitation

Rheumatic heart disease Prolapse Congenital (Ebstein’s) IE Radiation Carcinoid Blunt chest wall Trauma RV endomyocardial biopsy-related trauma Intra-annular RV pacemaker Implantable cardioverter-defibrillator leads

Aortic valve stenosis

Mitral valve regurgitation

Diastole

Tricuspid Stenosis

Rheumatic heart disease

Mitral valve stenosis

Aortic valve regurgitation

Alterations in hemodynamic function that accompany aortic valve stenosis, mitral valve regurgitation, mitral valve stenosis, and aortic valve regurgitation. The thin arrows indicate direction of normal flow and the thick arrows indicate the direction of abnormal flow. (Reprinted with permission from Porth C. Essentials of Pathophysiology . 4th ed. Philadelphia: Wolters Kluwer; 2015.)

Pulmonic Stenosis

Congenital disorder Less common etiologies include carcinoid and obstructing vegetations or tumors Primary follows childhood surgery for tetralogy of Fallot or other congenital lesions that may progress insidiously

Pulmonic regurgitation