NURSING

1. Presented by
Monika Devi
Msc. Nursing
HCN, SRHU
AORTIC STENOSIS

2. Definition
Aortic Stenosis is narrowing of the orifice between the left ventricle &
the aorta.

3. Pathophysiology
Aortic stenosis limits the forward flow of blood from LV
↓
↑ blood volume & pressure in the LV
↓
Left Ventricular hypertrophy & dilation
Blood form LA cannot get into LV
↓
LVF
↓
↑ Blood volume & pressure in LA

4. Cont…
↑ blood volume & pressure in LA
↓
LA hypertrophy & dilation
↓
↑ blood volume & pressure in pulmonary veins
↓
Pulmonary congestion
↓
↑ pulmonary arterial pressure
↓
↑ work for RV, right ventricular strain
↓
Right ventricular failure

5. Clinical Manifestations
 Many patients are asymptomatic
 Exertional Dyspnea
 Dizziness
 Syncope
 Angina pectoris
 BP may be low
 Low pulse pressure

6. Diagnostic Findings
 Assessment
 # A loud, rough systolic murmur is heard over aortic area.
 # Crescendo- decrescendo murmur- the murmur is low pitched, rough, rasping,
vibrating
 # If the examiner rests a hand over the base of the heart, a vibration may be felt
 ECG
 Echocardiography
 Cardiac catheterization
 Angiography

7. Management
 Antibiotic prophylaxis
 Surgical replacement of aortic valve
 One or two balloon percutaneous valvuloplasty procedures may
benefit in symptomatic patients

8. AORTIC REGURGITATION

9. Aortic Regurgitation
It is the back flow of blood into the LV from the aorta during
diastole

11. Causes
 Inflammatory lesions of the leaflets
 Endocarditis
 Congenital abnormalities - syphilis

12. Pathophysiology
Aortic regurgitation permits blood flow back into the LV
↓
↑ blood volume & pressure in the LV
↓
Left Ventricular hypertrophy & dilation Blood from LA cannot get into LV
↓
LVF
↓
↑ Blood volume & pressure in LA

13. Cont…
↑ blood volume & pressure in LA
↓
LA hypertrophy & dilation
↓
↑ blood volume & pressure in pulmonary veins
↓
Pulmonary congestion
↓
↑ pulmonary arterial pressure
↓
↑ work for RV, right ventricular strain
↓
Right ventricular failure

14. Clinical Manifestations
 Marked arterial pulsations that are visible or palpable at carotid or
temporal arteries
 Dyspnea
 Fatigue
 Signs & symptoms of LVF
 # breathing difficulties
 - orthopnea
 - paroxysmal nocturnal dyspnea

15. Diagnostic Findings
Assessment
 Widened pulse pressure.
 A high pitched, blowing, diastolic murmur is heard at 3rd or 4th intercostal
space.
 Water Hammer pulse (pulse strikes the palpating finger with a quick,
sharp stroke & then suddenly collapses)
 ECG
 Echocardiography
 Cardiac catheterization
 Angiography

16. Management
 Antibiotic prophylaxis therapy
 Treatment of CCF
Surgery:
 Aortic Valve Replacement OR Valvuloplasty, is preferred before
LVF

17. Nursing Management
 Teach about diagnosis, progressive nature of the diseases, treatment plan
 Assess the vital signs
 Assess the patient for signs & symptoms of Heart Failure
 Assess for dysrhythmias
 Assist in planning daily activities of patient

18. References

19. Thank You