Aortic

Stenosis
A narrowing or a stricture of the
aortic valve that results in
Resistance to blood flow in the
left ventricle
Decreased cardiac output
Left ventricular hypertrophy
Pulmonary venous and
pulmonary arterial hypertension
hypertrophy of the left
ventricular wall- hallmark
 Cause
Congenital heart defect

Calcium buildup on the valve

Rheumatic fever
 Risk
Factors

Bicuspid aortic Buildup of

valve calcium deposits
on heart valves

History of
rheumatic fever
 Stricture in the aortic outflow
tract
Resistance to the
ejection of blood from
Extra the left ventricle
workload at
the left Left Ventricle
ventricle
Hypertrophy
Left Ventricular Failure
develops
Left Atrial Pressure
increases
Increase pressure in the
pulmonary veins
Pulmonary edema

Signs and Symptoms:

Faint pulses
Hypotension
Tachycardia
Poor feeding
Exercise intolerance
Chest pain
Dizziness
Characteristic murmur
 COMPLICATIONS:

 Heart failure
 Arrhythmias
 Cardia Arrest
 Chest Pain

prevent rheumatic fever. 

PREVENT Untreated strep throat can develop into
ION! rheumatic fever.
 Diagnostic
Test: This test helps show blockages in arteries to
Cardiac your heart that can coexist with aortic valve
stenosis and may need surgical treatment along
Catheterization with aortic valve stenosis.

. An echocardiogram helps your doctor closely

examine the aortic valve to check for problems.
Echocardiogra A specific type of echocardiogram, a Doppler
echocardiogram, may be used to help your
m doctor determine the severity of your aortic
valve stenosis and to check for any leakage
(regurgitation).
 Can provide clues about whether the left
Electrocardiogr ventricle is thickened or enlarged, a problem
which can occur with aortic valve stenosis.
am
. Aortic valve stenosis may lead to blood and
Chest X- fluid backing up in your lungs, which causes
congestion that may be visible on an X-ray.
ray
 Nursing
Management
Instruct client to limit strenuous activities
Promote adequate rest
Assist in giving antibiotics prior to
invasive procedures
Advice pt to rest and sleep sitting in a chair
or bed with the head elevated when
experiencing symptoms
Advise to see a cardiologist every 3-6
months for monitoring
Instruct SO to call the doctor immediately
when the child experiences palpitations for
more than a short period of time
 Medical
Management
Antibiotic prophylaxis to prevent
endocarditis is essential for pts
undergoing invasive procedures.
Definitive treatment for aortic stenosis
is surgical replacement of the aortic
valve.
Pts who are symptomatic and are not
surgical candidates may benefit from
one- or two- balloon percutaneous
valvuloplasty procedures.
 Pharmacological
Inteventions
Antibiotics may be used for some people with aortic
stenosis:
People who had rheumatic fever in the past may need
long-term, daily treatment with penicillin.
Give antibiotics before dental work or an invasive
procedure. The antibiotics were given to prevent an
infection of the damaged heart valve. 
Oral amoxicillin and erythromycin , as well as
intramuscular or intravenous ampicillin, gentamycin,
and vancomycin.
Beta Blocker and Calium Channel Blocker
- to reduce cardiac hypertorphy before the defect
 Surgical
Nonsurgical techniq
Management
Balloon valvuloplasty (valvotomy). Occasionally, repairing the
aortic valve is an option. Balloon valvuloplasty uses a soft, thin
tube (catheter) tipped with a balloon. A doctor guides the
catheter through a blood vessel in your arm or groin to your heart
and into your narrowed aortic valve. Once in position, a balloon at
the tip of the catheter is inflated. The balloon pushes open the
aortic valve and stretches the valve opening, improving blood
flow. The balloon is then deflated and the catheter with balloon is
guided back out of your body. Balloon valvuloplasty may relieve
aortic valve stenosis and its symptoms, especially in infants and
children. However, in adults, the procedure isn't usually
successful, and the valve tends to narrow again even after initial
success. For these reasons, doctors rarely use balloon
valvuloplasty today to treat aortic valve stenosis in adults, except
in people who are too sick to undergo surgery.
Percutaneous aortic valve replacement. Aortic
valve replacement, the most common
treatment for aortic valve stenosis, has
traditionally been performed with open-heart
surgery. A new approach currently under study
has made it possible to perform the procedure
with a catheter. This option is available only on
a research basis and is usually reserved for
individuals at increased risk of complications
from aortic valve surgery.
 Surgical
Aortic valve surgery
Management
Aortic valve replacement. This is the primary surgical
treatment for aortic valve stenosis. Your surgeon removes
the narrowed aortic valve and replaces it with a mechanical
valve or a tissue valve. Mechanical valves, made from metal,
are durable, but they carry the risk of blood clots forming on
or near the valve. If you receive a mechanical valve, you'll
need to take an anticoagulant medication, such as warfarin
(Coumadin), for life to prevent blood clots. Tissue valves —
which may come from a pig, cow or human cadaver donor —
often need to be replaced. Another type of tissue valve
replacement that uses your own pulmonary valve (autograft)
is sometimes possible. Your doctor can discuss the risks and
benefits of each type of heart valve with you.
Valvuloplasty. In rare cases, surgical repair may
be more effective than balloon valvuloplasty,
such as in infants born with an aortic valve in
which the leaflets of the valve are fused
together. Using traditional surgical tools, a
cardiac surgeon operates on the valve and
separates these leaflets to reduce stenosis and
improve blood flow. Or valve repair may
involve removing calcium deposits on or near
the valve. This helps clear the valve
passageway.