aoritic stenosis

Question 1

clinical features of symptomatic disease

Answer 1

chest pain
dyspnoea
syncope/presyncope
murmur

Question 2

what type of murmur is seen typical in aortic stenosis?

Answer 2

• an ejection systolic murmur (ESM) is classically seen in aortic stenosis
• classically radiates to the carotids
• this is decreased following the valsalva manoeuvre

Question 3

features of severe aortic stenosis

Answer 3

narrow pulse pressure 
slow rising pluse 
delayed ESM 
soft/absent S2
S4 
thrill 
duration of murmur 
left ventricular hypertrophy or failure

Question 4

causes of aortic stenosis

Answer 4

degenerative calcification 
bicuspid aortic valve 
William's syndrome 
post-rheumatic disease 
subvalvular: HOCM

Question 5

management for asymptomatic patient

Answer 5

observe the patient

Question 6

management for symptomatic

Answer 6

valve replacement

Question 7

options for aortic valve replacement

Answer 7

surgical AVR is the treatment replacement of choice for young, low/medium operative risk patients.
transcatheter AVR is used for patients with a high operative risk.

Question 8

balloon valvuloplasty

Answer 8

may be used in children with critical aortic stenosis who are not fit for valve replacement.