calbay_ coarctation of the aorta

8/3/2019 Calbay_ Coarctation of the Aorta

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Prepared By:

Calbay, Christian Daniel Uy

BSN304


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HISTORY

PHYSICAL ASESSMENT

- General Appearance

- Pulse, Blood Pressure,

and Respirations


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DIAGNOSTIC TEST

Electrocardiogram

Radiography

Echocardiography

Phonocardiography & magnetic

resonance imaging Exercise testing

Laboratory tests


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Narrowing of the lumen of the aorta.


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is a narrowing of the aorta mostcommonly found just distal to the origin

of the left subclavian artery.

Most patients with coarctation havejuxtaductal coarctation.

Older terms, such as preductal(infantile-type) or

Postductal (adult-type), are often

misleading.


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High Blood Pressure

Bounding pulses in the arms

Weak or absent femoral pulses

Cool lower extremities with lower BP

Headache

Vertigo Epistaxis

CVA; leg pain


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ECHOCADIOGRAPHY - is the most commontest to diagnose this condition, and it may

also be used to monitor the patient aftersurgery.

Chest x-ray

Heart CT may be needed in older children

MRI or MR angiography of the chest may beneeded in older children

Cardiac catheterization and aortography


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Early presentation of coarctation of the aorta:

- Treatment in patients with congestive heart

failure (CHF) includes the use of diureticsand inotropic drugs.

- Prostaglandin E1 (0.05-0.15 mcg/kg/min) is

infused intravenously to open the ductus

arteriosus.

- Ventilatory assistance is provided to patients

with markedly increased work of breathing.


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- Infusion of inotropic drugs (dopamine,dobutamine, epinephrine) is useful when

ventricular dysfunction is present, especially

with hypotension.

- A Foley catheter is inserted to monitor renalperfusion and urine output.

- ABGs are tested to monitor acidosis.

- An umbilical artery catheter may be placed

in neonates to assess the response toprostaglandin infusion with regard to

improving lower-body blood flow.


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Resection with end-to-end anastomosis.This method involves removing the narrowedsegment of the aorta (resection) followed byconnecting the two ends of the aorta

together (anastomosis).

Patch aortoplasty. Your doctor may treatyour coarctation by cutting across theconstricted area of the aorta and thenattaching a patch of synthetic material towiden the blood vessel. Patch aortoplasty isuseful if the coarctation involves a longsegment of the aorta.


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Left subclavian flap angioplasty. A portionof the left subclavian artery, the blood vessel

that delivers blood to your left arm, may be

used to expand the narrowed area of the

artery.

Bypass graft repair. This technique involves

bypassing the narrowed area by inserting aplastic tube called a graft between the

portions of the aorta.


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Balloon angioplasty and stenting

is an option for initially treating aorticcoarctation or for treating re-narrowing (re-

coarctation) that has occurred after surgery.

During this procedure, your doctor inserts a

thin flexible tube (catheter) into an artery in

your groin and threads it up through your

blood vessels to your heart. An uninflated

balloon is placed through the opening of the

narrowed aorta. When the balloon is

inflated, the aorta widens and blood flowsmore easily. In some cases, a mesh-covered

hollow tube called a stent is inserted to keep

the narrowed part of the aorta open.


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Instruct patients to the prescribed

meds (Antihypertensive therapy)

Low salt, low fat diet

Regulating physical activity

Health education


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Decreased Cardiac Output (include murmur,cyanosis, tachypnea, arrhythmia if present)

Ineffective Tissue Perfusion

Impaired Gas Exchange r/t ventilation-perfusion imbalance AEB ... (include yoursubjective and objective data relating to a

child with this ND)

Ineffective Breathing Pattern (include labvalues)

Activity Intolerance


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PREPARED BY:

CALBAY CHRISTIAN DANIEL UY

BSN304

calbay_ coarctation of the aorta

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