Question

Match the symptom to the etiology. Symptoms may be used more than once. mitral stenosis chronic mitral regurgitation A. Palpitations B. Atrial fibrillation C. Exertional dyspnea D. Orthopnea E. Peripheral edema F. Paroxysmal nocturnal dyspnea G. Fatigue

Short answer

Mitral stenosis is associated with symptoms B, C, and G. Chronic mitral regurgitation is associated with symptoms A, B, C, D, E, F, and G.

Step-by-step solution

Understand Mitral Stenosis

Mitral stenosis is a condition where the mitral valve of the heart thickens, leading to a restricted blood flow. Symptoms include exertional dyspnea (difficulty in breathing upon exertion), atrial fibrillation (irregular heart beat), and fatigue.

Understand Chronic Mitral Regurgitation

Chronic mitral regurgitation, on the other hand, is a condition where the mitral valve doesn't close properly leading to backflow of blood. This condition's symptoms include palpitations, atrial fibrillation, exertional dyspnea, orthopnea (difficulty in breathing when lying flat), peripheral edema (swelling in the legs), paroxysmal nocturnal dyspnea (sudden awakening due to breathlessness and needing to be upright to breathe more comfortably), and fatigue.

Match Symptoms to the Disease

With a understanding of the two conditions and the related symptoms, we can match symptom to the etiology. Mitral stenosis is associated with Atrial fibrillation (symptom B), Exertional dyspnea (symptom C), and Fatigue (symptom G). Chronic mitral regurgitation is associated with Palpitations (symptom A), Atrial fibrillation (symptom B), Exertional dyspnea (symptom C), Orthopnea (symptom D), Peripheral edema (symptom E), Paroxysmal nocturnal dyspnea (symptom F), and Fatigue (symptom G).

Key concepts

Mitral Stenosis Education

Mitral stenosis is a cardiovascular condition characterized by the narrowing of the mitral valve in the heart. This narrowing hinders the blood flow from the left atrium to the left ventricle. As a result, the heart needs to work harder to pump blood through the narrowed valve, leading to several symptoms. Key symptoms include:

• Exertional Dyspnea: This is difficulty in breathing during physical activities. The heart's inability to efficiently pump blood causes fluid accumulation in the lungs, making it hard to breathe.
• Atrial Fibrillation: This irregular heartbeat often results from the high pressure in the upper chamber of the heart, causing it to become enlarged and disrupting its normal rhythm.
• Fatigue: The body's reduced blood and oxygen supply due to poor blood flow can cause persistent tiredness.

It is important for individuals with mitral stenosis to manage their symptoms through lifestyle changes such as avoiding excessive exertion and seeking medical treatment when necessary.

Chronic Mitral Regurgitation Education

Chronic mitral regurgitation occurs when the mitral valve does not close completely, allowing blood to flow backward into the left atrium when the left ventricle contracts. This leads to various symptoms that indicate compromised heart function including:

• Palpitations: This sensation of a racing or irregular heartbeat results from extra blood flow causing the heart to beat irregularly.
• Orthopnea: Patients may experience trouble breathing when lying flat due to fluid build-up in the lungs.
• Peripheral Edema: Excessive fluid in tissues, especially in the legs and ankles, results from the heart’s inefficiency in pumping blood.
• Paroxysmal Nocturnal Dyspnea: Sudden episodes of breathlessness at night occur due to fluid redistribution when lying down, requiring the patient to sit upright to breathe better.
• Fatigue and Exertional Dyspnea: Similar to mitral stenosis, these symptoms stem from insufficient oxygenated blood circulation.

Patients with chronic mitral regurgitation typically need medical evaluation to determine the best intervention approach, which may include medications or surgical options to repair or replace the valve.

Nursing Symptom Matching

In nursing practice, symptom matching is a critical skill for assessing and identifying possible underlying conditions. Both mitral stenosis and chronic mitral regurgitation present with overlapping symptoms, but careful evaluation can help in differential diagnosis. For instance:

• Atrial Fibrillation: Common in both conditions, but the cause may differ; in mitral stenosis, it results from increased pressure, while in mitral regurgitation, it is due to volume overload.
• Exertional Dyspnea and Fatigue: Present in both, related to poor blood flow in stenosis and volume overload in regurgitation.
• Orthopnea, Peripheral Edema, and Paroxysmal Nocturnal Dyspnea: These symptoms are more indicative of chronic mitral regurgitation.

Proper symptom matching leads to accurate diagnoses and tailored interventions. Nurses should gather a comprehensive history and assess patients thoroughly, considering both physical and diagnostic findings, to ensure optimal patient care.