Pulmonary stenosis: Nursing

The heart can be divided into a right and left side. The right side of the heart is responsible for pumping poorly oxygenated blood to the lungs, and the left side of the heart is responsible for pumping highly oxygenated blood out to the entire body.

Now, there are conditions that can affect the right side’s ability to pump effectively. These conditions, or heart defects, obstruct or decrease pulmonary blood flow, which ultimately leads to inadequately oxygenated blood.

These types of heart defects are primarily congenital, which means they were present at birth. Such defects include pulmonary stenosis, tetralogy of Fallot and tricuspid atresia.

Pulmonary stenosis, sometimes called pulmonic stenosis, occurs when there is narrowing of the pulmonic valve.

Though little is known about what causes it, genetic and environmental factors may play a role in its development.

Now, the narrowing of the valves obstructs normal blood flow through the pulmonary artery. This means less blood is making its way to the lungs.

Depending on the severity of the disease, this could cause no symptoms at all, like in mild cases; or dyspnea, fatigue and syncope in moderate cases; and cyanosis in severe cases. These symptoms also tend to worsen with exertion.

In moderate to severe cases of pulmonary stenosis, the right ventricle muscle can enlarge.

This happens because the right ventricle has to work harder to pump blood past the stiff, narrowed valve, and the harder that muscle has to work, the bigger it becomes.

This is known as hypertrophy. Now, a bigger ventricle muscle doesn’t mean a stronger pump. In fact, a hypertrophied ventricle actually doesn’t pump as effectively.

And over time, it can no longer pump enough blood to meet the body’s demand; we call this “heart failure.”

So this means even less blood is getting to the lungs and the symptoms associated with pulmonary stenosis worsen, coupled with new symptoms of right sided heart failure; like jugular vein distention, abdominal distention, peripheral edema and heart murmur.