aortic stenosis

Question 1

etiology?

Answer 1

calcifications
rheumatic fever

Question 2

pathophysiology?

Answer 2

narrow aortic valve -> LV outflow obstruction -> LV hypertrophy -> LV dysfunction (high O2 demand which is not met)

Question 3

symptoms?

Answer 3

exertional dyspnea, angina, syncope (SAD)

auscultation: ejection systolic murmur at second R intercostal space radiating to carotid
soft S2
S4 added sound
early systolic ejection click
pulsus parvus et tardus (weak delayed distal pulse)

Question 4

diagnosis?

Answer 4

echo
ECG (LVH: deep S in V1 V2, tall R in V5 V6 both added are >35mm)
LV strain (ST depression and twave inversion)

xray: calcified aortic valve

Question 5

treatment?

Answer 5

aortic valve replacement /repair