[4] Aortic Stenosis Flashcards
What happens when the left ventricle contracts?
It forces blood through the valve and into the aorta
What happens to the aortic valve when the left ventricle relaxes?
The aortic valve closes and prevents regurgitation
What occurs as a consequence of aortic valve stenosis?
The left ventricles must generate a higher pressure with each contraction to effectively move blood into the aorta. Initially, the LV generates this pressure with myocardial hypertrophy, however in later stages, the left ventricle dilates, the wall thins, and systolic function deteriorates
What are the risk factors for aortic stenosis?
- Smoking
- Hypertension
- High cholesterol
- Diabetes
- Male gender
- End-stage kidney disease
What are the causes of aortic valve stenosis?
- Age related progressive calcification of aortic valve
- Calcification of a congenital bicuspid aortic valve
- Acute rheumatic fever
- Faby disease
- Systemic lupus erythematosus
- Paget disaease
- Hyperuricaemia
- Infection
What do the symptoms of aortic valve stenosis depend on?
The degree of stenosis - most people with mild to moderate aortic stenosis don’t have symptoms, and symptoms usually present in individuals with severe aortic stenosis
What are the symptoms of aortic stenosis?
- Loss of consciousness
- Anginal chest pain
- Shortness of breath on exertion
- Nocturnal shortness of breath
- Oedema
What is involved in the diagnosis of aortic stenosis?
- Examination
- ECG
- Chest x-ray
- Echocardiogram
- Cardiac catheterisation
What are the examination findings in aortic stenosis?
- Pale, sweaty general appearance
- Increased heart rate
- Slow-rising pulse
- Pressure loaded, non-displaced apex beat
- Thrill in aortic area
What might the ECG show in aortic stenosis?
Abnormal patterns on ECG might reflect a thickened heart muscle
What might the CXR show in aortic stenosis
Usually shows a normal heart shadow, however the aorta above the aortic valve is often dilated. Sometimes calcification of the aortic valve can be seen
What might the CXR show if heart failure is present with aortic stenosis?
- Fluid in the lung tissue
- Larger blood vessels in the upper lung regions
What does echocardiography show in aortic stenosis?
Thickened, calcified aortic valve which opens poorly
May show abnormal size and functioning of heart chambers
How can the Doppler technique be utilised in aortic stenosis?
To determine the pressure difference on either side of the aortic valve, and to estimate the aortic valve area
What happens in cardiac catheterisation in investigation of aortic valve stenosis?
Small catheters are advanced under x-ray guidance to the aortic valve and into the left ventricle. Simultaneous pressures are measured on both sides, and the rate of blood flow across the aortic valve can also be measured. Using this data, the aortic valve area can be calculated.
