Pathophysiology, risk factors, signs and symptoms, diagnosis, and treatment of valvular heart disease, infective endocarditis, and rheumatic carditis.
Our Medical-Surgical video tutorial series is taught by Cathy Parkes BSN, RN, CWCN, PHN and intended to help RN and PN nursing students study for their nursing school exams, including the ATI, HESI and NCLEX.
0:00 What to Expect 0:28 Valvular Heart Disease 1:22 Risk Factors of Valvular Heart Disease 1:49 Signs and Symptoms of Valvular Heart Disease 2:08 Diagnosis of Valvular Heart Disease 2:18 Medications 2:28 Procedures 3:08 Nursing Care 3:31 Infective Endocarditis 3:58 Risk Factors of Infective Endocarditis 4:14 Signs and Symptoms of Infective Endocarditis 4:38 Diagnosis of Infective Endocarditis 4:56 Treatments 5:06 Rheumatic Carditis 5:55 Signs and Symptoms 6:07 Diagnosis 6:30 Treatments 6:45 Quiz Time!
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Content
0.4 -> Hi, I'm Cathy with Level Up RN. In this video, we
are going to talk about valvular heart disease,
6.24 -> infective endocarditis, and rheumatic carditis. At
the end of the video, I'm going to be giving you
12.96 -> guys a little quiz to test your understanding
of some of the key concepts I'll be covering
17.44 -> in this video. So definitely stay tuned
for that. If you have our Level Up RN
22.8 -> medical surgical nursing flashcards, definitely
pull those out so you can follow along with me.
28.64 -> First up, let's talk about valvular heart
disease, which is where we have a defect or damage
35.2 -> to one of the heart valves. So this can be the
tricuspid valve, the mitral valve, the aortic
41.2 -> valve, or the pulmonic valve. And this damage or
defect can cause stenosis of the valve, which is
49.12 -> narrowing of the valve. It can cause prolapse,
which is like improper closure of the valve,
56 -> and that can result in regurgitation. So normally
we want blood going all in one direction,
62.96 -> so from the atria to the ventricles. But if the
valve between the atria and ventricle is not
70.32 -> functioning properly, like what we
would see with valvular heart disease,
74.4 -> then that blood can regurgitate or flow
backwards from the ventricle to the atria.
82 -> In terms of risk factors associated with
acquired causes of valvular heart disease,
88.56 -> risk factors include hypertension,
older age, increased cholesterol,
95.44 -> smoking, diabetes, and other key risk factors
include rheumatic fever, as well as infective
103.12 -> endocarditis. And we will talk about those
conditions in depth in this video as well.
109.12 -> Signs and symptoms of valvular heart disease
can include murmurs, extra heart sounds,
114.88 -> such as S3 or S4 sounds, dysrhythmias, and
then with mitral stenosis or insufficiency,
123.12 -> dyspnea may be present in your patients,
so difficulty with breathing. In terms
128 -> of diagnosis of this disorder, we can utilize a
chest X-ray, an EKG, as well as an echocardiogram.
136.24 -> Medications that are useful in helping to treat
this condition include diuretics, digoxin,
143.36 -> antihypertensive agents, and anticoagulants.
In terms of procedures or surgeries,
151.2 -> if the patient has stenosis, we can use something
called a percutaneous balloon valvuloplasty.
158.64 -> So this is where we insert a balloon up into
the valve and we inflate it to help reduce that
165.28 -> narrowing when we have stenosis. We can also try
to do a valve repair surgically and ultimately
173.68 -> the patient may require a prosthetic valve.
So if your patient gets a prosthetic valve,
179.76 -> then they will require antibiotics prior to any
dental work, surgery, or other invasive procedure.
188.48 -> And as a nurse, you need to keep in mind that this
is actually required for any prosthetic device. So
195.52 -> my mom has a prosthetic knee as
well as a prosthetic shoulder,
200.32 -> so she has to take antibiotics before she goes to
the dentist or before she has any other invasive
206.32 -> procedure. So definitely keep that in mind
for your patients with prosthetic devices.
211.6 -> Next, we have infective endocarditis, which,
as I mentioned before, is a key risk factor
218.16 -> for valvular heart disease. So with
this disorder, we have bacteria or fungi
224.88 -> that adhere to the heart and form these
vegetative growths, which can lead to necrosis
232.4 -> of a heart valve or the endocardium, which is
the inner layer of the heart. Key risk factors
239.44 -> associated with this disorder include congenital
heart disease, valvular heart disease, prosthetic
246.4 -> bowels, as well as I.V. drug use. Signs and
symptoms of infective endocarditis include fever,
254.8 -> flu-like symptoms, murmurs, petechiae, which
are these red dots that form on the skin,
262.16 -> as well as something called splinter hemorrhages.
So if you haven't heard of this before, this is
267.68 -> where we have red streaks that form under the
nail bed, and this is definitely a unique feature
274.88 -> with infective endocarditis. In terms of
diagnosis, we're definitely going to want
280.16 -> to run blood cultures for a patient with suspected
infective endocarditis, and those blood cultures
286.88 -> will likely be positive for bacteria. We can
also use an echocardiogram to help diagnose
294.08 -> this disorder. In terms of treatment, we're going
to want to give the patient antibiotics to treat
299.28 -> the infection and then the patient may end up
needing a valve repair or a valve replacement.
307.12 -> Finally, we have rheumatic carditis,
which is inflammation of the heart
312.08 -> following a strep throat infection. So
an infection with group A beta hemolytic
319.12 -> streptococci bacteria. So this infection
triggers an autoimmune response in the body,
326.16 -> which is rheumatic fever. And this leads to the
development of inflammatory lesions in the heart.
333.6 -> And this can cause damage, long term damage,
to the heart and to the heart valves.
339.76 -> So it's going to be really important that any
time a patient is diagnosed with strep throat,
345.76 -> that they receive immediate treatment and we fully
treat that infection to avoid the development
352.48 -> of rheumatic carditis. In terms of
signs and symptoms, we have tachycardia,
359.2 -> cardiomegaly, so enlargement of the heart,
murmurs, possible friction rub, and chest pain.
367.12 -> In terms of diagnosis, we want to do a throat
culture to check for streptococcal infection. We
374.4 -> also want to run an ASO titer. So ASO stands for
Antistreptolysin. If the ASO titer is positive,
383.76 -> that means the patient developed antibodies
in response to a strep throat infection.
389.84 -> In terms of treatment, we obviously need to give
the patient antibiotics to treat the infection.
395.92 -> Depending on the amount of damage that was
done to the heart, the patient may also
400.8 -> require a valve repair or a valve replacement.
All right, quiz time. I have three questions for
408.24 -> you. First question. Splinter hemorrhages
are indicative of what cardiac disorder?
417.68 -> The answer is infective endocarditis.
Question number two. Rheumatic fever
425.04 -> is a risk factor for the development of
valvular heart disease. True or false?
433.68 -> The answer is true. Third question.
What lab will be positive in a patient
441.04 -> with rheumatic carditis? And there are
two possible answers with this one.
447.76 -> The answer is, they will have a positive
throat culture for strep throat, and they
454 -> may also have a positive ASO titer, so if you
said either of those, then you are correct.
460.8 -> Okay, that's it for this video. I hope it's
been helpful. If so, be sure to leave me a
466 -> comment and thank you so much for watching.
I invite you to subscribe to our channel and share
471.2 -> a link with your classmates and friends in nursing
school. If you found value in this video, be sure
476.88 -> and hit the like button, and leave a comment and
let us know what you found particularly helpful.
