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Aquired Valvular Heart Disease

Aortic Valve

Aortic Valve Insufficiency


Aortic 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

Etiology
Congenital 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: Patients 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: Patients 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

Aging Hypertension Infective endocarditis Trauma

Aortic Regurgitation

Sign and Symptoms


Dyspnea on exertion Orthopnea Palpitations Angina pectoris Cyanosis

Circulatory shock

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: