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Cardiac catheterization case study
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Aortic stenosis is a narrowing of the aortic valve. The aortic valve is a gate-like structure that is located between the lower left chamber of the heart (left ventricle) and the blood vessel that leads away from the heart (aorta). When the aortic valve is narrowed, it does not open all the way. This makes it hard for the heart to pump blood into the aorta and causes the heart to work harder. The extra work can weaken the heart over time and may lead to heart failure.
Aortic stenosis can range from mild to severe. If untreated, it can become more severe over time.
CAUSES
This condition may be caused by:
• Buildup of calcium around the valve. This can occur with aging. This is the most common cause of aortic stenosis.
• Birth defect.
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This is a type of imaging test that uses sound waves (ultrasound) to produce an image of your heart. There are two types that may be used: o Transthoracic echocardiogram (TTE). o Transesophageal echocardiography (TEE). This type of echocardiogram is done by passing a flexible tube down your esophagus. The heart is located in front of the esophagus. Because the heart and esophagus are close to each other, your health care provider can take very clear, detailed pictures of the heart using this type of test.
• Cardiac catheterization. In this procedure, a thin, flexible tube (catheter) is passed through a large vein in your neck, groin, or arm. This procedure provides information about your heart structures as well as blood pressure and oxygen levels within your heart chambers.
• Electrocardiogram (ECG). This records the electrical impulses of your heart and assesses heart function.
• Stress tests. These are tests that evaluate the blood supply to your heart.
• Blood tests.
TREATMENT
Treatment depends on how severe your condition is and what your symptoms are. You will need to have your heart checked regularly to make sure that your condition is not getting worse or causing serious problems. If your condition is mild, no treatment may be
Transcatheter aortic valve replacement or TAVR is the latest technology used principally for the treatment of aortic stenosis, a condition in which one of the major valves of the heart, the aortic valve, becomes tight and stiff, usually as a result of aging (3). Since many patients who need aortic valve replacement for aortic stenosis are too sick to undergo major valve replacement surgery, they are unable to get the treatment they need. With the transcatheter aortic valve, this issue is bypassed because this valve can be implanted in the heart by accessing the patient’s heart through an artery in the groin. The valve can be inserted through a wire that can be pushed to the heart, and the old valve is simply pushed to the side when the new valve is implanted. This technology has been in use in the US with Edwards’ Sapiens valve since 2011 and has saved the lives of many patients with aortic stenosis (4).
Left-sided holodiastolic, murmur with point of maximal intensity over the left base. The murmur is decrescendo shaped.
The purpose for the stent was to hold the coronary artery open to allow the blood to flow more freely.
There are four different categories of treatment: lifestyle changes, surgical procedures, non-surgical procedures, and medications. Lifestyle changes include having a healthy diet; increasing physical activity; eliminating cigarettes, alcoholic beverages, and illicit drugs; and getting enough rest and sleep; losing excess weight. These lifestyle changes are to lower the patient’s blood pressure, cholesterol, and reducing any other future medical conditions. There are also surgical options to help cure, prevent, or control cardiomyopathy. Surgical method include a septal myectomy, surgically implanted devices, and a heart transplant. A septal myectomy is used to specifically treat hypertrophy cardiomyopathy which is where the heart muscle cells enlarge and cause the walls of the ventricles to thicken. The thickening of the walls may not affect the size of the ventricles but instead may affect the blood flow out of the ventricle. Usually along with the ventricles swelling, the septum in between the ventricles can become enlarged and block the blood flow causing a heart attack. When medication is not working well to treat hypertrophic cardiomyopathy, a surgeon will open the chest cavity and remove part of the septum that is blocking blood flow. Surgically implanted devices include a pacemaker, a cardiac resynchronization therapy device, a left ventricular assist device, and an implantable
Sever Aortic Stenosis (AS) is a major cause of mortality and morbidity in elderly duo to a bimodal age distribution ,degenerative calcification of Tricuspid valve is the major cause of AS in the population ,unlike the younger patient etiology which is : bicuspid valve calcification or rheumatic heart disease .1
An artery is an elastic blood vessel that transports blood away from the heart. There are two main types of arteries: pulmonary arteries and systemic arteries.
Endovascular stent graft repair is designed to help reinforce a weakened aorta. Endovascular surgery is performed inside the aorta using thin, long tubes called catheters to place a stent surrounded with a fabric liner. Endovascular stent grafting uses an endovascular stent graft to reinforce the wall of the aorta and to help keep the damaged area from rupturing and developing into a potentially serious health problem that can be fatal and cause massive internal bleeding.
For example, heart and lung transplants. This is a solution if a patient’s hole in the heart cannot be healed or helped with another form treatment. Several different targeted therapies have been done to improve health of ES patients. Disease-targeting therapies have proven to be successful in Idiopathic Pulmonary Arterial Hypertension (IPAH) and have been analyzed to in their effectiveness against ES. Prostanoid therapy in patients with ES has also shown the possibility that therapy may improve oxygen saturation, exercise capacity, and even shows a decrease Pulmonary Vascular Resistance (PVR). This is backed by a study with eight patients that have ES, these results were after 3 months of therapy. Another study is being done in a method called Vasodilator therapy. In these case studies, a drug name prostacyclin improved hemodynamics sufficiently enough to ensure ES patients for surgery to repair the cardiac lesion. Other studies have shown that Phosphodiesterase Type-5 Inhibitors, were used in patients with ES. In these studies, observation over a six-month period allowed the researchers to see improvements in oxygen saturation and cardiopulmonary hemodynamics (Beghetti and Galiè, 2009). Research from these studies is also being combined with different medical treatment to target therapies and is it possible to reverse pulmonary vascular
The aorta is the largest artery in the body, responsible for the transfer of oxygenated blood from the heart to every organ of the body. Understandably, any disruption in the integrity of the aorta could have catastrophic consequences. An aortic dissection occurs when a tear in the inner layer of the aorta develops. As the tear expands, blood will eventually begin to spill out of the tear and continue down the aorta in between the inner layer and outer layer. As the inner and outer layers begin to separate from each other, they develop into what is called a true and false lumen. An aorta can dissect in various ways. Those different types of dissection are then classified as Type A, B and Type I through III. Type A involves the ascending aorta. Type B does not involve the ascending aorta2. Type I involves the entire aorta, Type II involves only the ascending aorta, and Type III originates in the descending aorta and extends distally and does not involve the ascending aorta or arch.2 Dissections that originate in the descending aorta and then progressively dissect proximally are still considered Type III.
than 9 square centimeters, was placed on the patient's chest at various angles. The transducer delivered ultrasound waves into the body and these
Coronary heart disease is defined by the hardening of the epicardial coronary arteries. The buildup of plaque in the arteries slowly narrows the coronary artery lumen. In order to better understand the physiology of the disease, it is important to first know the basic anatomy of the human heart. The aorta, located in the superior region of the heart, branches off into two main coronary blood vessels, otherwise known as arteries. The arteries are located on the left and right side of the heart and span its surface. They subsequently branch off into smaller arteries which supply oxygen-rich blood to the entire heart (Texas Heart Institute, 2013). Therefore, the narrowing of these arteries due to plaque buildup significantly impairs blood flow throughout the heart.
Atherosclerosis is the most common cause of CAD. Atherosclerosis is a progressive disease characterized by fat deposits in the arteries causing them to block the normal passage of blood. No one is quite sure how atherosclerosis develops. The plaque consists mostly of cholesterol, phospholipids and smooth muscle cells. They also reduce the size of the lumen of the affected artery which impairs the blood flow of this artery and later on could form a thrombus that will completely occlude the vessel. “Unfortunately, signs and symptoms of atherosclerosis usually don’t develop until at least 70% of an artery’s lumen has become obstructed. Angina is almost always the first symptom to appear.”(Journal: The killer behind CAD,2010). Modifiable factors that could prevent the occurrence of CAD include cigarette smoking, obesity, physical inactivity, atherogenic diet like diet high in cholesterol, use of contraceptive and hormone therapy replacement. “Women continue to ...
Most often the disease starts in the left ventricle, and then often spreads to both the atrium and right ventricle as well. Usually there will also be mitral and tricuspid regurgitation, due to the dilation of the annuli. This regurgitation will continue to make problems worse by adding excessive volume and pressure to the atria, which is what then causes them to dilate. Once the atria become dilated it often leads to atrial fibrillation. As the volume load increases the ventricles become more dilated and over time the myocytes become weakened and cannot contract as they should. As you might have guessed with the progressive myocyte degeneration, there is a reduction in cardiac output which then may present as signs of heart failure (Lily).
Atherosclerosis is a disease that occurs when arteries become blocked, inflamed, or hardened. As a result of this, blood cannot easily pass through the artery, and blood pressure increases. Many people suffer from atherosclerosis as they age, but young people can be affected by atherosclerosis also. There are many preventative steps that can be taken to decrease the risk of atherosclerosis; however, if atherosclerosis does develop in the arteries, medications can be given to help the individual receive adequate blood flow to important tissues. Atherosclerosis is a very serious condition that requires medical attention and a change in life style because it is a precursor to many dangerous and potentially fatal diseases.