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Aortic Valve
Aquired Valvular Heart Disease
Aortic Valve InsufficiencyAortic valve consists of three
leaflets.It mediates the flow of blood from the left ventricle to the aorta and the rest of the body.
Results when the leaflets do not completely seal the aortic orifice and allows a backflow of blood from the aorta into the left ventricle.
Aortic Stenosis
Aortic Stenosis
Aortic valve stenosis is a type of valvular heart disease characterized by an abnormal narrowing of the aortic valve opening.
When the aortic valve becomes progressively narrowed, a pressure gradient is created between left ventricle and the aorta.
Aortic Stenosis
Initially, the left ventricle compensates by thickening of its walls in order to maintain adequate systolic function in order to overcome the increased load caused by the stenotic aortic valve.
Aortic Stenosis
EtiologyCongenital bicuspid aortic valve
(30-40% of cases).Acute rheumatic fever (less
than 10% of cases).Age related.
Aortic Stenosis
Sign and Symptoms
Angina Pectoris
Chest pain
Orthopnea
Dyspnea on exertion
Fatigue
Aortic Stenosis
Diagnostic Tests
• Electrocardiogram (ECG)• Heart catheterization• Echocardiogram• Chest X-ray
Aortic Stenosis
Medical Treatment
Any angina is generally treated with short-acting nitrovasodilators, beta-blockers and/or calcium blockers
Any hypertension is treated aggressively, but caution must be taken in administering beta-blockers
Any heart failure is generally treated with digoxin, diuretics, nitrovasodilators and, if not contraindicated, cautious inpatient administration of ACE inhibitors
Aortic Stenosis
Nursing Diagnosis: Activity intolerance related to imbalance between oxygen supply and demand.
Evaluation: Patient’s condition will improve within few days.
Intervention:• Assess vital sign of the patient
• Administer oxygen as prescribed by doctor - To reduce oxygen requirement and chest pain.• Encouraging patient not to do much activities - To decrease cardiac workload
Outcome: Patient’s condition shows some improvement.
Aortic Regurgitation
Aortic Regurgitation
Is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle.
Aortic Regurgitation
When the pressure in the left ventricle falls below the pressure in the aorta, the aortic valve is not able to completely close.
This causes a leaking of blood from the aorta into the left ventricle.
Aortic Regurgitation
This means that some of the blood that was already ejected from the heart is regurgitating back into the heart.
Aortic Regurgitation
Etiology
AgingHypertensionInfective endocarditisTrauma
Aortic Regurgitation
Dyspnea on exertion
Orthopnea
Palpitations
Angina pectoris
Cyanosis
Circulatory shock
Sign and Symptoms
Aortic Regurgitation
Medical Treatment
• ACE inhibitors • Angiotensin II receptor antagonists • Nifedipine• Hydralazine
Aortic Regurgitation
Nursing Diagnosis: Activity intolerance related to diminished cardiac output.
Evaluation:
Intervention:• Restrict fluids and diuretics as ordered - To reduce pulmonary congestion• Administer oxygen as ordered - To reduce oxygen requirement
Outcome:
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