(^64) Medical-Surgical Nursing Demystified
PROGNOSIS
The prognosis may be chronic with stabilization of symptoms, or acute, usually
after myocardial infarction, leading to valve replacement.
HALLMARK SIGNS AND SYMPTOMS
- Orthopnea due to the pressure rising into the atria, causing backflow into the
lungs. - Fatigue because of an ineffective heart.
- Systolic murmur at the apex, S3 gallop.
- Left ventricular hypertrophy—the size of the ventricle can reflect the amount
of regurgitation.
INTERPRETING TEST RESULTS
- Echocardiogram shows the underlying etiology of the insufficiency.
- Cardiac catheterization depicts the flow through the mitral valve; can mea-
sure amount of regurgitation as well as pressures in the chambers.
TREATMENT
Patients with chronic, stable disease may be managed for years without symptoms,
or their symptoms may be under control with medication. Others may require sur-
gery, again, based on the symptoms. Ventricular damage may occur before symp-
toms present, so frequent monitoring is indicated.- Administer vasodilators to reduce flow by lowering systemic vascular
resistance. - Administer anticoagulant medication following surgery to prevent thrombus
around the aortic valve:- heparin
- warfarin
- enoxaparin
- Mitral valve repair or replacement.