Aortic Stenosis Flashcards
What is aortic stenosis?
Narrowing of the three cusps that form the aortic valve
How is an aortic stenosis murmur described?
High pitched ejection systolic murmur
Crescendo-decrescendo in character
Radiates to the carotids
What causes the aortic stenosis murmur to decrease?
Valsalva manoeuvre
How is the pulse affected in someone with aortic stenosis?
Narrow pulse pressure
Slow rising pulse
What is the main cause of aortic stenosis in patients over 65?
Degenerative calcification
What are the main cause of aortic stenosis in patients younger than 65?
Bicuspid aortic valve
What are possible clinical signs someone with aortic stenosis could present with?
chest pain
Murmur
dyspnoea
syncope / presyncope (e.g. exertional dizziness)
How is aortic stenosis diagnosed?
ECG
What changes might you see on an ECG in someone with Aortic Stenosis?
- L – LBBB – due do calcification
- L – Left Axis Deviation
- L – LVH
- P – Poor R wave progression (i.e. depolarisation of the ventricles is slow)
What is the management of aortic stenosis if the patient is symptomatic?
Valve replacement
Is long term anticoagulant therapy required for valve replacement?
Not for prosthetic valve replacement
For metal valve replacement
What is the management of aortic stenosis if the patient is asymptomatic?
Observation
What should patients be given if they are receiving a valve replacement?
Antibiotics to prevent bacterial endocarditis
What are the other possible causes of aortic stenosis?
William’s syndrome
Rheumatic heart disease
Which patients would be offered surgical intervention for ortic stenosis?
Symptomatic aortic stenosis
Asymptomatic patients with a left ventricular ejection fraction (LVEF) < 50% (valvular gradient >40mmHg)
When would patients be offered transcatheter valve replacement over surgical valve replacememt?
Severe comorbidities
Previous heart surgery
Frailty
Restricted mobility
Older than 75 years of age.
When might balloon valvuloplasty be offered to patients?
Children- no aortic valve calcification
Adults who are not fit for valve replacement
What can an ECHO be used for in someone with aortic stenosis?
To diagnosed and assess then severity of aoartic stenosis
What can a chest x-ray be used for in someome presenting with aortic stenosis?
To look for calcification of the valves
What medication can be given to relieve symptoms of aortic stenosis?
Furosemide
What medication is contraindiated in aortic stenosis?
Nitrates
