Advanced Pathophysiology for the Advanced Practice Nurse
Aortic Stenosis, Pathophysiology, Treatment, Nursing Implications
Critical Care Nursing | Medicine and Health Sciences | Nursing
Aortic Stenosis is the progressive and permanent narrowing of the aortic valve that is located between the left ventricle and the aorta. The pathophysiology is endothelial damage to the valve resulting in lipid penetration, calcific changesand valve stiffness.Major risk factors for aortic stenosis are natural aging>60 years(atherosclerotic changes in vasculature) and male gender.In the early phases of aortic stenosis, the body compensatesvia hypertrophy of the left ventricle to accommodateforthe increased pressure gradient. Progression is typically over years to decades untildecreased outflow of blood leads toinadequate perfusion to major organsystems including the heart itself. Patientsdo not typically have symptoms until flow is severely obstructed with a valve diameter <1.0 cm². When patientsdevelop symptoms (primarily heart failure symptoms: syncope, exercise intolerance, chest pain), the stenosis is severe,and prognosis is poor without treatment. Currently, there are no pharmacological treatments proven to slow progression of aortic stenosis. Therefore, patients must undergo surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). TAVR procedures are designed to be a safer alternative for older individuals who donot meet the criteria for SAVR candidacy. A case study involving a 97-year old male who underwent a TAVR is discussed. In conclusion, aortic stenosis is the progressive narrowing of the aortic valve caused by endothelial damage that leads to valve stiffening and decreased outflow. Once the valve obstructs flow, heart failure can arise and ultimately causes death if not treated.
Lower, Christina, "Aortic Stenosis" (2020). Nursing Student Class Projects (Formerly MSN). 452.