QLexNursing

◼️Valvular heart disease (VHD) refers to damage or defect in one or more of the heart valves (aortic, mitral, tricuspid, or pulmonary), leading to either stenosis (narrowing) or regurgitation (leakage) of blood flow.

◼️Rheumatic heart disease (RHD) is one of the most significant and preventable causes of acquired valvular disease globally.

◼️It develops after untreated or inadequately treated Group A Streptococcal pharyngitis, which triggers an autoimmune inflammatory reaction that damages the heart valves—especially the mitral and aortic valves.

◼️The inflammatory process results in fibrosis, leaflet thickening, and commissural fusion, causing the classic rheumatic murmur that indicates valvular involvement.

◼️The presence of a cardiac murmur after a history of rheumatic fever is a hallmark of valvular pathology.

◼️Clients with rheumatic fever or RHD are at high risk for progressive valve dysfunction, heart failure, atrial fibrillation, and infective endocarditis due to the damaged endothelial surface, which becomes a nidus for bacterial colonization.

◼️Nursing management includes monitoring for signs of heart failure, encouraging adherence to prophylactic antibiotics (e.g., penicillin), and educating clients on infection prevention, as secondary infections can further worsen valve damage.

◼️Other causes of valvular disease include congenital malformations, degenerative changes (especially in older adults), and infective endocarditis, but rheumatic etiology remains a classic and preventable cause recognized by the presence of a murmur and inflammatory cardiac history.