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Recognizing aortic and mitral valve disease

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GENERAL PURPOSE To provide nurses with an overview of aortic and mitral valve disease.

LEARNING OBJECTIVES After reading the preceding article and taking this test, you should be able to:

  1. Identify pathophysiology associated with aortic and mitral valve disease.
  2. List clinical manifestations of aortic and mitral valve disease.
  3. Identify management strategies for patients with aortic or mitral valve disease.

1. Which statement is correct about the aortic valve?

a. From 1% to 2% of Americans have a congenital tricuspid aortic valve.

b. A normal aortic valve has two leaflets.

c. Over time, a normal aortic valve can become calcified.

d. The aortic valve is located between the left atrium and left ventricle.

2. Which statement is correct about aortic stenosis?

a. Aortic stenosis hinders blood flow from the right ventricle during systole.

b. Left ventricular pressure goes down with aortic stenosis.

c. Aortic stenosis is the most common valve dysfunction in the United States.

d. Aortic stenosis usually is an acute process.

3. The three cardinal symptoms of aortic stenosis are angina, exertional dyspnea, and

a. ascites.

b. peripheral edema.

c. a third heart sound (S3).

d. syncope.

4. The gold standard for diagnosing aortic stenosis is

a. a chest X-ray.

b. a TTE.

c. an ECG.

d. a stress test.

5. Which drug can be prescribed to slow the progression of degenerative calcific aortic stenosis?

a. statins

b. diuretics

c. nitrates

d. antithrombotics

6. Causes of acute aortic regurgitation include

a. congenital bicuspid valve.

b. collagen-vascular disease.

c. systemic hypertension.

d. aortic dissection.

7. The murmur of aortic regurgitation usually is heard best at the

a. apex.

b. right second intercostal space.

c. lower right sternal border.

d. left second to fourth intercostal spaces.

8. A loud aortic murmur with a palpable thrill is described as

a. Grade 1.

b. Grade 3.

c. Grade 4.

d. Grade 6.

9. Treatment goals for symptomatic chronic aortic regurgitation include increasing

a. stroke volume.

b. left ventricular afterload.

c. regurgitant volume.

d. left ventricular end-diastolic volume.

10. The most common cause of mitral stenosis is

a. atrial myxoma.

b. infective endocarditis.

c. rheumatic fever.

d. calcification.

11. Common signs and symptoms of mitral stenosis include

a. high-pitched systolic murmur.

b. syncope.

c. angina.

d. dyspnea.

12. The preferred diagnostic study for mitral stenosis is

a. a transesophageal echocardiogram.

b. a chest X-ray.

c. an ECG.

d. a TTE.

13. A patient with mitral stenosis and AF will most likely be treated with

a. furosemide.

b. warfarin.

c. digoxin.

d. enalapril.

14. Which statement is correct about treating mitral regurgitation?

a. Surgery isn't indicated until the patient is symptomatic.

b. Patients with class I heart failure undergo prophylactic surgery.

c. Mitral valve repair is favored over replacement.

d. Surgery is indicated once the EF falls below 70%.

15. Aortic murmurs are heard best when the patient

a. sits up and leans forward.

b. is supine.

c. is in the right lateral decubitus position.

d. is in the left lateral position.

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Figure

© 2005 Lippincott Williams & Wilkins, Inc.