B.

Aortic stenosis
Definition:
Is the obstruction of blood flow across the aortic valve.

Etiology
In most children, the cause isn't known. It's a common type of heart defect. Some children can have other heart defects along with AS.

SIGNS AND SYMPTOMS: If there is mild aortic stenosis, the infant may grow normally to be asymptomatic until increased physical growth requires additional cardiac output. Dizziness Fainting Becoming tired or fatigued with exertion more easily than others (in mild cases) Serious breathing problems that develop within days or weeks of birth (in severe cases)

The most prominent physical manifestation of aortic stenosis is the presence of a coarse systolic ejection murmur, usually accompanied by a thrill over the aortic area, radiating to the neck and apex.

Children with mild or moderate aortic stenosis may get worse as they get older. They also run the risk of developing a heart infection (bacterial endocarditis). Diagnostic Test The following tests may be performed: Chest radiography- may show normal heart or there may be signs of left ventricular enlargement with dilatation of the aorta in the poststenotic area electrocardiogram (ECG or EKG) findings may be normal even when there is moderate to severe obstruction but there may be an evidence of varying degrees of left ventricular hypertrophy echocardiogram (echo) helpful in analysing the cause of the changes in heart sounds

Surgical Management

Aortic Valve Replacement is a cardiac surgery procedure in which a patient's failing aortic valveis replaced with an alternate healthy valve. The aortic valve can be affected by a range of diseases; the valve can either become leaky (aortic insufficiency / regurgitation) or partially blocked (aortic stenosis). Aortic valve replacement is open heart surgery.

Aortic valvuloplasty - is the repair of a stenotic aortic valve using a balloon catheter inside the valve. The balloon is placed into the aortic valve that has become stiff from calcium buildup. The balloon is then inflated in an effort to increase the opening size of the valve and improving blood flow. Heart Valve Repair is a surgical technique used to fix defects in heart valves in valvular heart diseases, and provides an alternative to valve replacement. Nursing Management

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Provide a bedside commode because using a commode puts less stress on the heart than using a bedpan. Offer diversional activities that are physically undemanding. Alternate periods of rest to prevent extreme fatigue and dyspnea. To reduce anxiety, allow the patient to express his concerns about the effects of activity restrictions on his resposibilities and routine. 5. Keep the patients legs elevated while he sits in a chair to improve venous return in the heart. 6. Place the patient in an upright position to relieve dyspnea. 7. Administer oxygen as needed to prevent tissue hypoxia. 8. Allow the patient to express his fears and concerns about the disorder, its impact on his life, and any impending surgery. 9. Monitor the patients vital signs, weight, and intake and output for signs of fluid overload. 10. Regularly assess the patients cardiopulmonary function.