The first type of valvular heart defect is aortic stenosis. That is the obstruction of flow from the left ventricle to aorta. The etiology involved with aortic stenosis includes congenital abnormality, degenerative wear and tear, and rheumatic fever. Mild to moderate stenosis is not usually accompanied by symptoms. With severe stenosis, a patient will exhibit fatigue, dyspnea, syncope, and angina pectoris. (Oakes)

The clinical manifestations include an increased respiratory rate, increased heart rate, decreased pulse, and decreased systolic blood pressure. Auscultation will either be normal or

Clinical manifestations of mitral insufficiency in chronic compensated cases are a decreased pulse, skin will be cool and warm with cool extremities, increased respiratory rate, and mental Status will be alert and fatigued. Lung sounds, ABG values, blood pressure, pulse pressure, neck veins, urinary output, capillary refill, and heart rate will all be normal. (Oakes)

In cases of compensated aortic insufficiency, no treatment may be needed except for maybe prophylactic antibiotics. In decompensated cases, surgery is definitive. In acute cases, emergency surgery is required for management. (Oakes)

The types of valvular heart disease that have been covered in this paper are only the most commonly effected; the valves of the left heart. Right heart valvular disease is rare, but is increasing do to the number of non-sterile intravenous drug users. (Oakes) Valvular heart disease is responsible for more than 18,500 deaths each year in the United States and is a contributing factor in about 38,000 deaths. The majority of these cases involve disorders of the aortic valve (63 percent) and the mitral valve (14 percent). Deaths due to pulmonic and tricuspid valve ( both in the right heart) disorders are more rare (3 percent each). (Shappell) Proper treatment and diagnosis of valvular heart disease is essential to maintain quality health and extend life expectancy.

Severe mitral regurgitation may cause falsely elevated mixed venous oxygen saturation (SvO2). (Pilbeam)

In acute or decompensated cases of mitral insufficiency the respiratory rate will be increased with dyspnea. Auscultation will reveal crackles and wheeze. ABGs will reflect a respiratory alkalosis changing to a metabolic acidosis. Heart rate will be increased with arrhythmias, pulse will be pulse alterans. The neck veins will be distended and urinary output decreased. The skin will be cool, clammy, and ashen w

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