Diagnosing and Treating Mitral Regurgitation

Cardiovascular Alterations
From the information provided, the diagnosis would be mitral regurgitation that is possibly caused by dilated cardiomyopathy. Mitral regurgitation is a condition that causes the abnormal flow of blood back from the left ventricle (LV) to the left atrium (LA) during ventricular systole, which produces a systolic murmur that is heard loudest at the cardiac apex (Acker et al., 2014). The murmur also radiates into the axilla and back. This condition is normally caused by disruption of any part of the mitral valve apparatus. The leakage can cause there to be an increase in blood volume and pressure within the area. This increased blood pressure in the left atrium can result in an increase in pressure in the veins that lead from the lungs to the heart (Acker et al., 2014). Severe regurgitation will result in increased pressure that can cause congestion in the lungs. Symptoms of the disorder might be hard to establish in a patient because the patient could have normal results. The disorder might also not have any symptoms. As the was the case with the patient in the case, all examinations were within normal limits and they did not have any history of cardiac death in their family.
Diagnosis and Treatment
Since the patient did not have any history of cardiac illness and there is no family history of the same, then the best way to diagnose the condition would be by preliminary mitral valve diagnosis could be made by listening to the heart through a stethoscope by an experienced physician. Chest radiology can also be used to show if there is pulmonary congestion and the enlargement of the left atrium and left arteries. Diagnosis can also make use of an electrocardiogram (ECG or EKG). This will show left atrial enlargement, atrial fibrillation, right ventricular hypertrophy in advanced cases. An echocardiograph can also be utilized in order to diagnose the condition and to determine the best course of treatment. This exam can also indicate the progress of the condition and how effective the administered medication is on the condition. The nurse can also make use of stress and exercise tests. Making use of different tests will assist in measuring the patient's tolerance to activity and help to monitor the patient's heart response to physical exertion.
Treatment for the condition is dependent on its severity. Considering that the patient did not have any symptoms and they were not experiencing any signs of the condition, then the goal for treatment would have been to avoid future complications. The patient could be monitored and evaluations carried out regularly (Goldstein et al., 2016). The frequency of the evaluations would be dependent on how the condition is progressing. As it is well known there is no medication that can treat the condition. Therefore, any medication prescribed would be aimed at treating the symptoms and not the condition. The medications that can be prescribed include diuretics, blood thinners, and high blood pressure medications. Diuretic medication will relieve the fluid accumulation in the patient's lungs. Blood thinners will ensure that no blood clots are formed. High blood pressure medication would only be prescribed if the patient has high blood pressure. The best treatment for the condition is surgery to repair or replace the diseased valve (Goldstein et al., 2016).
The selected patient factor is behavior. Since the patient was taking part in sports game then there was a need to ensure that they are evaluated at least every two weeks in order to determine the progression of the condition. This evaluation would be vital since the patient might be participating in sports that elevate his blood pressure, which would increase the heart's force for pumping blood. An ECG exam would be conducted for the patient. Treatment will involve surgery in order repair or replace the valve. This would be a permanent solution instead of insisting that the patient would modify their lifestyle and not take part in stressful sporting activities.


References
Acker, M. A., Parides, M. K., Perrault, L. P., Moskowitz, A. J., Gelijns, A. C., Voisine, P., . . . Puskas, J. D. (2014). Mitral-valve repair versus replacement for severe ischemic mitral regurgitation. New England Journal of Medicine, 370(1), 23-32.
Goldstein, D., Moskowitz, A. J., Gelijns, A. C., Ailawadi, G., Parides, M. K., Perrault, L. P., . . . Gillinov, A. M. (2016). Two-year outcomes of surgical treatment of severe ischemic mitral regurgitation. New England Journal of Medicine, 374(4), 344-353.