Aortic stenosis: pathophysiology, diagnosis, and medical management of nonsurgical patients

As the average lifespan continues to increase, nurses are managing more patients with aortic stenosis. When an asymptomatic patient begins to manifest signs and symptoms due to progressive narrowing and stiffening of the aortic valve, the only effective therapy is surgical replacement of the valve. But, some patients cannot undergo or do not opt for surgery. Nurses are challenged by the tenuous balance between the narrow range of preload and afterload to maintain forward blood flow and adequate cardiac output in patients with severe aortic stenosis. Understanding the complex normal anatomy and physiology of the aortic valve can help nurses appreciate the consequences of this type of stenosis. Nursing care for patients with aortic stenosis requires advanced skills in patient assessment and an appreciation of the hemodynamic responses to activities of daily living and to nursing interventions such as administration of medications.