side by side comparison

Valve Disorders: Aortic vs Mitral — Stenosis and Regurgitation Patterns

A systolic murmur could be aortic stenosis or mitral regurgitation — but the location, radiation, and symptoms point to completely different pathology and urgency. Picking the wrong valve on the NCLEX means misidentifying the surgical candidate and choosing the wrong priority assessment.

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Comparison

Side-by-side2 compared
Dimension
Aortic Valve Disorders
Mitral Valve Disorders
Pathophysiology & hemodynamics
  • Stenosis then LV pressure overload, hypertrophy
  • Regurg then LV volume overload + dilation
  • Calcific degeneration, bicuspid valve
  • Stenosis then LA dilation, pulmonary congestion
  • Regurg then LA & LV volume overload
  • Rheumatic disease, prolapse, post-MI
Murmur, location & symptoms
  • ★Stenosis: systolic crescendo-decrescendo, RUSB→carotids
  • Regurg: diastolic blowing decrescendo
  • Stenosis triad: syncope, angina, dyspnea
  • ★Stenosis: diastolic rumble + opening snap, apex→axilla
  • Regurg: holosystolic blowing at apex
  • Stenosis: dyspnea, hemoptysis, A-fib
Diagnostics
  • Echo grades severity, area, gradient
  • LVH on ECG
  • Regurg surgery: LVEF/LVESD criteria
  • Echo grades severity
  • LA enlargement/A-fib on ECG
  • Regurg surgery: LVEF <60% or LVESD ≥40 mm
Nursing priorities
  • ★Avoid vasodilators in severe stenosis
  • Monitor exertional syncope
  • caution preload-lowering
  • ★Monitor for A-fib, thromboembolism
  • Assess lung sounds
  • anticoagulate per order
Management
  • Stenosis: valve replacement (TAVR/SAVR)
  • Mechanical valve then lifelong warfarin INR 2–3
  • Stenosis: balloon valvotomy/replacement
  • Mechanical valve then warfarin INR 2.5–3.5
Patient teaching
  • Report syncope, chest pain, dyspnea
  • Warfarin: INR checks, diet, bleeding signs
  • Endocarditis ppx before dental if prosthetic
Red flags — escalate
  • Syncope or chest pain on exertion
  • Acute decompensated heart failure
  • New A-fib with rapid rate
  • Acute pulmonary edema
Complications
  • Left heart failure, sudden cardiac death
  • A-fib, LA thrombus, embolic stroke
  • Pulmonary hypertension then right HF
Pathophysiology & hemodynamics

Aortic Valve Disorders

  • Stenosis then LV pressure overload, hypertrophy
  • Regurg then LV volume overload + dilation
  • Calcific degeneration, bicuspid valve

Mitral Valve Disorders

  • Stenosis then LA dilation, pulmonary congestion
  • Regurg then LA & LV volume overload
  • Rheumatic disease, prolapse, post-MI
Murmur, location & symptoms

Aortic Valve Disorders

  • ★Stenosis: systolic crescendo-decrescendo, RUSB→carotids
  • Regurg: diastolic blowing decrescendo
  • Stenosis triad: syncope, angina, dyspnea

Mitral Valve Disorders

  • ★Stenosis: diastolic rumble + opening snap, apex→axilla
  • Regurg: holosystolic blowing at apex
  • Stenosis: dyspnea, hemoptysis, A-fib
Diagnostics

Aortic Valve Disorders

  • Echo grades severity, area, gradient
  • LVH on ECG
  • Regurg surgery: LVEF/LVESD criteria

Mitral Valve Disorders

  • Echo grades severity
  • LA enlargement/A-fib on ECG
  • Regurg surgery: LVEF <60% or LVESD ≥40 mm
Nursing priorities

Aortic Valve Disorders

  • ★Avoid vasodilators in severe stenosis
  • Monitor exertional syncope
  • caution preload-lowering

Mitral Valve Disorders

  • ★Monitor for A-fib, thromboembolism
  • Assess lung sounds
  • anticoagulate per order
Management

Aortic Valve Disorders

  • Stenosis: valve replacement (TAVR/SAVR)
  • Mechanical valve then lifelong warfarin INR 2–3

Mitral Valve Disorders

  • Stenosis: balloon valvotomy/replacement
  • Mechanical valve then warfarin INR 2.5–3.5
Patient teaching

Aortic Valve Disorders

  • Report syncope, chest pain, dyspnea
  • Warfarin: INR checks, diet, bleeding signs

Mitral Valve Disorders

  • Endocarditis ppx before dental if prosthetic
Red flags — escalate

Aortic Valve Disorders

  • Syncope or chest pain on exertion
  • Acute decompensated heart failure

Mitral Valve Disorders

  • New A-fib with rapid rate
  • Acute pulmonary edema
Complications

Aortic Valve Disorders

  • Left heart failure, sudden cardiac death

Mitral Valve Disorders

  • A-fib, LA thrombus, embolic stroke
  • Pulmonary hypertension then right HF

★ marks the fact that sets a column apart.

Clinical Pearl

Systolic + syncope = aortic stenosis. Diastolic rumble + A-fib = mitral stenosis. Timing + symptoms name the valve.

Component Topics

Aortic Valve DisordersMitral Valve Disorders

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