...he term mitral valve prolapse was coined by J. Michael Criley in 1966 and gained acceptance over the other descriptor of "billowing" of the mitral valve, as first described by John Brereton Barlow. This is why it is also referred to as Barlow’s Syndrome. Mitral valve prolapse, or MVP, is defined as a valvular heart disorder in which one or both mitral valve flaps close incompletely during systole usually producing either a click or murmur and sometimes produces minor mitral regurgitation. Both the anterior and posterior leaflets are composed of three layers of tissue: the atrialis, fibrosa, and spongiosa. Patients with classic mitral valve prolapse have excess connective tissue that thickens the spongiosa and separates collagen bundles in the fibrosa. This weakens the leaflets and adjacent tissue, resulting in increased leaflet area and elongation of the chordae tendineae. Although mitral valve prolapse is a lifelong disorder, many people with this condition never have symptoms. When diagnosed, people may be surprised to learn that they have a heart condition. When signs and symptoms do occur, it's typically because of mitral regurgitation. Mitral valve prolapse symptoms can vary widely from one person to another. They tend to be mild, develop gradually and may include arrhythmia, dizziness or lightheadedness, difficulty breathing or shortness of breath, often when lying flat or during physical activity, fatigue, coughing, and chest pain that’s not caused by a heart attack...
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...a. Depolarization b. Repolarization 2. What is a dysrhythmia, how does they affect CO? 3. Define premature ventricular contraction. How is it reflected in the EKG? 4. What are the causes for premature ventricular contraction? 5. What is an electrophysiology study and what are the nursing care considerations? 6. What is V-Tach? 7. How is it diagnosed? 8. What are the nursing care considerations associated with vtach? 9. What medications would be given and how would CPR and defibrillation be done? 10. What is ventricular fibrillation, nursing care, meds, dx, CPR, defib? 11. How do implantable cardioverter defibrillators work and what are the nursing considerations? 12. Describe premature atrial contractions. 13. Define A-fib, nursing considerations, and complications. 14. What is countershock and how does it work, what should you avoid? 15. How do antidysrhythmics work, what are they? 16. What is sick sinus rhythm? 17. What is a heart block and describe the differences between the different kinds. 18. Define nursing care for bradycarida including meds. 19. What are artificial pacemakers, what are the nursing considerations? 20. What are the different pacemaker modes? 21. What are the nursing considerations for pacemakers including medications? Coronary Circulation Disturbances 1. Outline the basic coronary circulation. 2. What is atherosclerosis and what does it effect? 3. Outline the progression of atherosclerosis. 4. What are the incidence of...
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...one of the four heart valves: the mitral, aortic, tricuspid or pulmonary. These conditions occur largely as a result of ageing. Most people are in their late 50s when diagnosed, and more than one in ten people over 75 have it. According to Professor Ben Bridgewater, consultant cardiac surgeon at University Hospital of South Manchester, ‘If the disease is picked up early, the outcomes from surgery are very good. Life expectancy goes back to match that of healthy people the same age. 2. The normal functions that would be affected by the disease. Normally functioning valves ensure that blood flows with proper force in the proper direction at the proper time. In valvular heart disease, the valves become too narrow and hardened to open fully, or are unable to close completely. Many of the symptoms are similar to those associated with congestive heart failure, such as shortness of breath and wheezing after limited physical exertion and swelling of the feet, ankles, hands or abdomen. Other symptoms include: * Palpitations, chest pain (may be mild). * Fatigue. * Dizziness or fainting (with aortic stenosis). * Fever (with bacterial endocarditis). * Rapid weight gain. 3. Changes in function caused by the disease There are many different types of valve disease; some types can be present at birth (congenital), while others may be acquired later in life. Congenital valve disease. Most often affects the aortic or pulmonic valve. Valves may be the wrong size...
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...Arrhythmias * Are common and often benign, but can indicate underlying heart disease. They often occur intermittently and so can be difficult to diagnose. * Can present with palpitations, chest pain, presyncope/syncope, hypotension, pulmonary oedema. Some are asymptomatic e.g. AF. * History taking make sure include: * Precipitating factors, onset, nature (fast/slow, regular/irregular), duration, associated symptoms (chest pain, dyspnoea, collapse). * Causes: * CARDIAC: * MI. * CAD. * LV aneurysm. * Mitral valve disease. * Cardiomyopathy. * Pericarditis. * Myocarditis. * Aberrant conduction pathways. * NON-CARDIAC: * Caffeine. * Smoking. * Alcohol. * Pneumonia. * Drugs (β2 agonist, digoxin, L-dopa, tricyclics). * Metabolic imbalance (K, Ca, Mg, hypoxia, hypercapnia, acidosis, thyroid disease, phaeochromocytoma). * Tests: * Bloods: FBC, U&E, glucose, Ca, Mg, TSH. * ECG: look for signs of IHD, AF, short P-R interval, long QT interval, U waves. * If ECG normal consider doing 24 hour tape. * Echo: look for structural heart disease. * Others: exercise ECG, cardiac catheterisation etc. * Types of Arrhythmias: * Bradycardias: * If asymptomatic and rate >40bpm then no treatment. * Look for cause and stop any drugs that may be the...
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...Angiodysplasia can be defined as the presence of abnormal, ectatic, dilated, tortuous and usually small (<10 mm) blood vessels within the mucosal and submucosal layers of the gastrointestinal tract. In this condition the affected vessels appear, at histologic examination, as thin, tortuous with the absence of an internal elastic layer. The pathophisiology is still unknown, but this condition tend to be acquired after chronic degenerative process associated with aging. It was suggested that angiodysplasia develops after chronic repeated muscolar contraction resulting in an increased intraluminal pressure with partial obstruction of the veins. Veins and venules start draining into submucosal vein with dilatation of the capillary ring and consequently due to the high pressure a small arteriovenous communication develops. Gastric angiodysplasias are an uncommon cause of upper gastrointestinal bleeding. They may be associated with underlying predisposing factors like hereditary hemorrhagic telangiectasia syndrome or patients undergoing hemodialysis. Idiopathic angiodysplasias are more common, typically occur in patients older than 60 years and are incidentally found in 1-2% of all asymptomatic patients undergoing colonoscopy. Most angiodysplasias will never bleed, but those that do make up 5% of overt upper GI bleeds. Clinically patients may present with hematemesis, melena, or chronic gastrointestinal blood loss resulting in anemia with associated iron deficiency. Endoscopic...
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...CASE STUDY: Mrs. F., a 56 year old Caucasian woman, was admitted to the Cardiac Step-Down unit with complaints of increasing shortness of breath on exertion, weight gain of 10 pounds in the last month, and difficulty sleeping without sitting straight up on three pillows. History: CABG X 2 with aortic value replacement in 1991, mitral valve regurgitation, HTN, CHF, hyperlipidemia, Type II DM, asthma, DJD, anxiety, and recently diagnosed with sleep apnea following 3 sleep studies with a CPAP prescribed at HS. Mrs. F. works as a cosmetologist instructor. She states she has been unable to walk across the school campus without stopping several times to “catch her breath”. She states she has faithfully been taking her medications. She has not been sick or around anyone with any type of infection recently. Assessment: Neurological- able to follow commands, moves all extremities without difficulty, A&OX3. Respiratory-Lungs sounds are diminished in all lobes both anteriorly and posteriorly. No wheezing or crackles present. Respirations are 20 with noted use of accessory muscles. SATs are 96% on 4L of O2 via nasal cannula. Cardiovascular-Heart rate is regularly-irregular at 65 bpm. Telemetry monitor shows NSR with controlled a fib. Trace pitting edema in noted bilaterally in the lower extremities. GI-Patient is obese. Abdomen is slightly distended. Last BM was this am. A cardiac, 1800 ADA diet is prescribed. GU-Patient voids clear yellow urine without difficulty...
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...Conditions that contribute to turbulent blow flow include increased blood velocity, structural valve defect, valve malfunctions, and abnormal chamber opening (Potter, Perry, Hall, & Stockert, 2013). Hypertension is a condition that can cause increased blood flow throughout the heart is. Hypertension is associated with thickening and loss of elasticity in the arterial wall causing the heart to continually pumps against greater resistance((Potter, Perry, Hall, & Stockert, 2013). The classification for adults to be considered hypertensive is to have a systolic reading 140 or greater and a diastolic reading 90 or greater. Modifiable risk factors that contribute to hypertension are obesity, cigarette smoking, heavy alcohol consumption, high sodium intake, sedentary lifestyles, and continued exposure to stress. Incidences of hypertension are greater in patients with diabetes, older adults, and African Americans and contributing factors for heart attacks ((Potter, Perry, Hall, & Stockert, 2013). Mitral value prolapse could be another indicator of a heart murmur. The mitral value is located between the left atrium and left ventricle. . Mitral valve prolapse occurs when the two leaves of the mitral valve...
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...Left Atrial pressure (LAP) 16 mm Hg Right ventricular pressure (RVP) 44/8 mm Hg Heart sounds revealed valvular regurgitation 1. Answer all questions with material that explains your answer. Yes/no answers receive NO credit. 2. Submit this as a hard copy double spaced typed paper. 3. Total possible 25 points 1. Based on the information provided, which A-V valve is incompetent? Why did you choose this set of valves? What is this condition called? (3pts) Based on the information it looks like the mitral valve is incompetent. According to Web MD, the mitral valve is a valve that lets blood flow from one chamber of the heart, the left atrium, to another called the left ventricle. The mitral valve is most likely to blame here for the regurgitation because of the left atrial and left ventricular problems, which allowed the backflow into the left atrium. This patient’s mitral valve is malfunctioning, this condition is called mitral valve prolapse. Mitral valve prolapse is a condition in which the two valve flaps of the mitral valve do not close smoothly or evenly. I chose this valve because their valve is swelling in the left atrium and left ventricle. This condition is should be monitored because the left side of the heart has to work harder than the right side. 2. Which heart sound would be pronounced and lengthened? Explain why they sound this...
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...lungs; then gets distributed to the rest of the body. There are four chambers of the heart: The Left and Right Atrium and the Left and Right Ventricles. These chambers act like containers to hold a certain amount of volume in order to continue pushing the blood to the valves of the heart. The sequence of blood flow happen simultaneously as the heart contracts and relaxes; knowing the normal process of blood flow can help distinguish what can go wrong in any patient. For example a valve that does not close all the way can cause blood to backflow and impair the function of...
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...Mitral valve insufficiency causes regurgitation of stroke volume back to the low pressure left atrium and remodeling of the heart walls. Remodeling of the heart walls leads to progressive left-sided cardiomegaly in an attempt to compensate for decreased stroke volume but becomes a cascade of continued dysfunctional changes with no return to normal stroke volume. Stretching of the mitral annulus from remodeling increases the regurgitant orifice and regurgitant volume. A vicious cycle ensues in an attempt to compensate for dysfunctional changes by further remodeling.3,11 The majority of remodeling occurs prior to the onset of clinical signs with the most rapid changes occurring in the six months prior to onset of CHF.3,7 Animal models for mitral...
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...Marfan Syndrome: A Brief Overview Abstract This paper will discuss the etiology and pathology of Marfan syndrome. It will also explore the signs and symptoms of the genetic disorder. Finally, it will discuss some of the available treatments, quality of life and prognosis of some one affected by Marfan syndrome. Marfan Syndrome: A Brief Overview Marfan syndrome was first described in 1896 by a French pediatrician by the name of Antoine Marfan (1858-1942). Marfan syndrome is a genetic disorder that affects the connective tissue in the body. The three main body systems that Marfan syndrome attacks are they eyes, bones and muscles, and the cardiovascular system. Marfan syndrome is also known as arachnodactyly in Greek and translates to “spider-like fingers” because of the elongated bones in the hands and fingers. Marfan syndrome is caused by a mutation on chromosome 15 that affects the production of fibrillin. Fibrillin is a protein that is responsible for allowing tissues to stretch repeatedly with out weakening. With this fibrillin defect, people with Marfan syndrome have hypermobility in their joints causing them to become weak and very loose. Another characteristic of Marfan syndrome is that some patients have excessively long limbs with an arm span greater than their height. The external affects of Marfan syndrome very greatly even with patients in the same family. The severity of Marfan syndrome is different from person to person. According to Rebecca J. Frey’s...
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...Heart Health Center Image Collection: Human Anatomy Picture of the Heart © 2009 WebMD, LLC. All rights reserved. The heart is a muscular organ about the size of a fist, located just behind and slightly left of the breastbone. The heart pumps blood through the network of arteries and veins called the cardiovascular system. The heart has four chambers: * The right atrium receives blood from the veins and pumps it to the right ventricle. * The right ventricle receives blood from the right atrium and pumps it to the lungs, where it is loaded with oxygen. * The left atrium receives oxygenated blood from the lungs and pumps it to the left ventricle. * The left ventricle (the strongest chamber) pumps oxygen-rich blood to the rest of the body. The left ventricle’s vigorous contractions create our blood pressure. The coronary arteries run along the surface of the heart and provide oxygen-rich blood to the heart muscle. A web of nerve tissue also runs through the heart, conducting the complex signals that govern contraction and relaxation. Surrounding the heart is a sac called the pericardium. Heart Conditions * Coronary artery disease: Over the years, cholesterol plaques can narrow the arteries supplying blood to the heart. The narrowed arteries are at higher risk for complete blockage from a sudden blood clot (this blockage is called a heart attack). * Stable angina pectoris: Narrowed coronary arteries cause predictable chest pain or discomfort with...
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...Rheumatic fever and Valvular Heart Disease also contributed to Heart Failure. This condition may affect the right side, the left side, or both sides of the heart. Rheumatic heart disease refers to the cardiac manifestations of rheumatic fever, including pancarditis (myocarditis, pericarditis, and endocarditis) during the early acute phase and chronic valvular disease later. Long-term antibiotic therapy can minimize recurrence of rheumatic fever, reducing the risk of permanent cardiac damage and eventual valvular deformity. In valvular heart disease, three types of mechanical disruption can occur; stenosis, or narrowing, of the valve opening: incomplete closure of the valve; or prolepses of the valve. They can result from such disorders as endocarditis (most common), congenital defects, and inflammation, and they can lead to heart failure. When the heart valve malfunction is significant, the heart eventually fails to pump properly, leading to congestive heart failure (CHF). With heart failure, many organs don't receive enough oxygen and nutrients, which damages them and reduces their ability to function properly. Most areas of the body can be affected when both sides of the heart fail. As the heart's...
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...or underlying heart disease, you may need treatment to help you feel better and treat the underlying problems. There are many underlying causes of the premature ventricular contractions, these include: 1. Infarct 2. Hypertension 3. Cardiomyopathy, including congestive heart failure 4. hypomagnesemia (blood magnesium levels). 5. hypokalemia (low blood potassium levels) 6. valvular heart disease, such as mitral valve prolapse 7. Hypokalemia and hypomagnesemia may occur, for example, in patients taking diuretics (water pills), hypoxia occurs in conjunction with lung diseases such as emphysema and chronic obstructive pulmonary disease. Most ectopic is not felt by the affected person. This is due to the fact that...
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...Since how long you have this chest pain? This question will tell, if the pain is acute or chronic that is having occurred recently or is present from a long period of time. For example pain of stable angina lasts less than 15 minutes while that of heart attack lasts more than 30 minutes. Similarly pain due to pulmonary embolism is of few minutes old while that of pneumonitis is present since hours or days. This should be kept in mind that more acute the symptoms the more chances of mortality. Patient can also be experiencing fleeting pain that is the pain come and goes. This happens in the case of mitral valve prolapse. At this point GP will also determine if the patient have ever experienced such pain in the past. Differential diagnosis: 1. Cardiovascular: • ACS/CAD/Angina • Aortic dissection • Aortic stenosis • Arrhythmias • Cardiac tamponade • Cardiomyopathy • Mitral valve prolapse • Pericarditis • Valvular heart disease 2. Respiratory/pulmonary: • Asthma • Pleurisy • Pneumonia • Pneumothorax • Pulmonary embolism • Foreign Body 3. Gastric: • Esophageal spasm • Esophagitis • Gastroesophageal reflux disease • Diverticular disease • Gastritis 4. Musculoskeletal: • Arthritis • Neuropathic pain • Costochondritis • Fibromyalgic • Muscular strain • osteoid osteoma • Trauma Assessment: After asking these questions a general practitioner should examine the patient. First he should record the vital signs including patient’s temperature, heart rate, respiratory rate, and blood pressure...
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