Aortic Stenosis ☺️ Flashcards

1
Q

Epidemiology

Etiology

A

Narrowing of aortic valve restricting flow from LV => A
May also affect LA pressure

65+ - degenerative calcification
U65 - bicuspid aortic valve
Supravalvular stenosis - William syndrome
Subvalvular stenosis - HOCM
Post rheumatic fever (AI reaction post GAS)

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2
Q

Presentation of aortic stenosis

-findings on examination

A

Syncope, angina, dyspnoea
Ejection systolic murmur => carotid radiation, decreased with Valsalva
Slow rising, narrow pulse pressure
-soft S2 (reduced force of closure)
-S4 (atria contract against hypertrophied LV)
-reverse splitting (P2A2)
LVH

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3
Q

Investigations

A

CXR - assess for cardiomegaly
ECG - assess for LVH
Echo - visualise valve movements
Angiogram - rule out coronary issues

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4
Q

Management

  • unstable
  • asymptomatic
  • symptomatic
A

Unstable - balloon valvuloplasty in cath lab
Stable and asymptomatic
-observe unless valvular gradient 40mmHg+ AND LV systolic dysfunction => valve replacement surgery
Stable and symptomatic
- valve replacement

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