The 50-year-old previously healthy patient complains of shortness of breath, especially on exertion or when laying down to sleep. She takes over-the-counter allergy medicine for seasonal allergies and melatonin to help her sleep sometimes. Her vital signs are heart rate of 64 bpm, respirations 22, oxygen saturation 99%, and blood pressure 114/68 mmHg. Her assessment is notable for crackles over the bilateral lung bases and a moderate diastolic apical murmur. Her electrocardiogram is normal. Her echocardiogram shows normal function of the left ventricle and severe stenosis of the mitral valve. The nurse provides which information to the patient?

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“After the procedure, you will have to lie flat in bed for 6-8 hours to protect the insertion site in your groin.”. In the young patient with mild symptoms, a balloon valvuloplasty is the treatment of choice. It is performed in the cardiac catheterization lab; a sheath is inserted into the femoral artery so a wire can be threaded into the heart. It is imperative the patient lie flat and still to protect the insertion site in the groin and prevent hemorrhage. If the patient were older with worse symptoms, a mitral valve replacement might be indicated. This would require prophylactic antibiotics before dental work and pain control for the cracked chest. The patient will likely require future procedures, such as open heart surgery to replace the stenotic mitral valve.

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