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Mitral valve prolapse: physical assessment complications and management
Authors:A H Hunt
Abstract:This article presents the fundamental knowledge nurse practitioners need when managing the care of a client with mitral valve prolapse (MVP). The assessment discussion includes information on where and how to perform cardiac auscultation, and it also includes a discussion of the particular mid-to-late systolic click with murmur that is typical of MVP. Client preparation for diagnostic tests (echocardiogram and ECG) is also presented. Potential complications of endocarditis, mitral regurgitation, ventricular dysrhythmia, chest pain, systemic emboli and sudden death are discussed. Particular emphasis is given to the nursing management and client teaching that are required for clients with MVP. Nursing management includes teaching the client 1) the need and schedule for chemoprophylaxis of endocarditis, 2) how to maintain left ventricular volume, 3) the possible relationship between chest pain and hypovolemia and 4) the advantages of regular exercise. Changes in the click-murmur that may occur with pregnancy and the impact of MVP on contraception and childbearing decisions are discussed. Specific nursing diagnoses that may arise with the client with MVP are listed. Outcome criteria that may be used for evaluation of nursing care are provided.
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