Valvular Heart Disease: NCLEX Priorities
Aortic and mitral stenosis vs regurgitation: murmurs, symptoms, management.
Valvular disease patterns on NCLEX: location and timing of murmur, symptoms, and when surgery.
Aortic stenosis
Systolic ejection murmur at right upper sternal border, radiates to carotids. SAD triad: Syncope, Angina, Dyspnea. Surgery (SAVR or TAVR) for symptomatic severe AS.
Aortic regurgitation
Diastolic blowing murmur at left sternal border. Wide pulse pressure, water-hammer pulse. Vasodilator (ACE) for chronic. Surgery for symptomatic severe AR.
Mitral stenosis
Diastolic rumble at apex. Often from rheumatic fever. AFib common. Balloon valvuloplasty.
Mitral regurgitation
Holosystolic murmur at apex radiating to axilla. Often from MVP, ischemia. Surgery or transcatheter repair.
Frequently asked
Pre-op valve surgery, prep?
Optimize HF, treat AFib, dental clearance, antibiotic prophylaxis prior.
Mechanical vs bioprosthetic valve?
Mechanical: lifelong warfarin. Bioprosthetic: shorter anticoagulation but valve degrades faster.
Quick check
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