Mitral Valve Regurgitation – Cardiovascular System Example

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"Mitral Valve Regurgitation" is a remarkable example of a paper on the cardiovascular system. From the given symptoms, the patient is suffering from Mitral valve regurgitation. This is a severe case of classic mitral valve prolapse. The valve dysfunction is triggered by her history of rheumatic fever, which might have detected one of the four heart valves. Diagnosis of this condition was made after physical examination that revealed her distended jugular veins, low pitched rumbling systolic murmur of the heart, and an extra ‘ S3’ heart sound; this showed that the patient is asymptomatic. Which term more accurately describes the stress placed upon T. H.’ s heart increased preload or increased afterload and why? The term that accurately describes the stress placed upon the patient’ s heart is increased preload and decreased afterload of the left ventricle.

This is caused by the expulsion of some of the stroke volume into the left atrium, as the dysfunctional valve is unable to close completely; therefore, allowing blood to leak back to the chamber it was recently. Incessant leakage may trigger a clot in the heart leading to cases of a stroke or pulmonary embolism (McCance & Huether, 2009).

The term increased preload means that there is an increase of forwarding blood flow across the valve; this determines the discharge coefficients of the valve region. The left ventricle, therefore, experiences much pressure as more energy is required to expel the blood via the tight valve. This means that the left ventricular experiences stress due to blood flow resistance. Valve dysfunction leads to the production of pressure preload caused by abnormal blood flow from the left ventricle into the left atrium in the course of systole.

Because of augmented pressure in the pulmonary system, congestive heart failure will be the resultant (Porth, & Porth, 2011). How might T. H.’ s body compensate for the above condition? Due to the stress placed upon the heart of the patient by the dysfunctional ventricular; the body comes up with ways to compensate this matter.   The left ventricle and left atrium compensate this by dilatation thus increasing the stroke volume. This is because the patient is experiencing end-diastolic pressure that extends to the right or left ventricle of the heart as per the physiologic demand.

There is an upsurge of atrial diastolic pressure across the heart valves.   In addition, the walls of the left ventricle thicken. This is done to make up for the poor pumping action of the heart. The heart size enlarges as well, due to valve dysfunction (Brashers, 2006). Also, there is calcification because of the narrowing effect of the affected valve (Rajamannan, 2013). How the body compensates for the stress imposed on the heart leads to the loss of performance and elasticity; that is the enlargement of the heart and thickening of the valves.

As this condition advances, the right atrium and right ventricle enlarge; this results to stressing the systolic function (Nixon & American Heart Association, 2011). A chest X-ray reveals a cardiac silhouette that is normal in diameter. Does this rule out a possible problem with T. H.’ s heart? Explain. No, this is because, in the chest radiography procedure, the cardiac size/ silhouette is normal in all patients who have valve conditions. This, therefore, does not rule out a possible problem with the patient’ s heart.

This is evident from the rounding of the left ventricular border and apex caused by hypertrophy (Henein et al. , 2012). Further examinations have to be conducted on the patient so that the actual condition can be determined. Despite the fact that the chest x-ray shows normal results, the heart must be examined based on the extra ‘ S3’ sound heard and low pitched rumbling systolic murmur. Examples of correct medical tests that can diagnose the issue with the heart of the patient are MSCT, ECG, CXR, and cardiac magnetic resonance (Otto, 2012).

References

Brashers, V. L. (2006). Clinical applications of pathophysiology: An evidence-based approach. St. Louis (MO: Mosby/Elsevier.

Henein, M. Y., Sheppard, M. N., Pepper, J., & Rigby, M. L. (2012). Clinical echocardiography.London: Springer.

McCance, K. L., & Huether, S. E. (2009). Pathophysiology: The biologic basis for disease in adults and children. S.l.: Mosby Inc.

Nixon, J. V., & American Heart Association. (2011). The AHA clinical cardiac consult.Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Otto, C. M. (2012). The practice of clinical echocardiography. Philadelphia, PA:Elsevier/Saunders.

Porth, C., & Porth, C. (2011). Essentials of pathophysiology: Concepts of altered health states. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Rajamannan, N. M. (2013). Cardiac valvular medicine. London: Springer

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