Aortic Stenosis Flashcards
What is the most common primary heart valve disease?
Degenerative calcification
Degenerative calcification is a leading cause of heart valve disease.
What are the two common types of congenital aortic valve disease?
- Bicuspid aortic valve (BAV)
- Unicuspid aortic valve (very rare)
Bicuspid aortic valve is the most common congenital heart valve malformation.
What is the LV response to increased afterload?
LVH
LVH stands for Left Ventricular Hypertrophy, a condition where the muscle wall of the heart’s left ventricle thickens.
What structural abnormality occurs in the aorta due to significant chronic aortic stenosis?
Post stenotic dilation
This refers to the dilation that occurs in the aorta above the stenotic valve, often seen in cases of aortic stenosis.
Fill in the blank: The condition characterized by left ventricular hypertrophy is a response to increased _______.
afterload
True or False: Post stenotic dilation occurs below the valve in cases of aortic stenosis.
False
Post stenotic dilation occurs above the valve (ascending aorta).
Is lvh eccentric or concentric when having LVH from AS
Eccentric
What clinical sign can result from low cardiac output?
Syncope
Syncope can lead to dizziness and loss of consciousness.
Fill in the blank: _______ is a symptom associated with low cardiac output.
Syncope
What are some symptoms associated with syncope?
- Dizziness
- Loss of consciousness
What does elevated venous filling pressures lead to?
Exertional Dyspnea
What type of murmur is associated with cardiac auscultation?
Harsh, systolic ejection murmur (crescendo-decrescendo)
This type of murmur is often indicative of aortic stenosis or other conditions affecting blood flow.
What is an early systolic sound commonly found in BAV?
Early systolic ‘click’
BAV stands for Bicuspid Aortic Valve, which is a congenital heart defect.
What are the surgical replacement options for symptomatic aortic stenosis (AS)?
Surgical Aortic valve replacement (SAVR), Transcatheter aortic valve replacement (TAVR), Balloon valvuloplasty
What does SAVR stand for?
Surgical aortic valve replacement
What types of valves can be used in SAVR?
Mechanical or porcine (pig) valves
Which surgical replacement option is the most popular?
Transcatheter aortic valve replacement (TAVR)
What is Balloon valvuloplasty?
A balloon put in the Aortic valve that is a temporary fix for aortic stenosis
Who are the typical candidates for Balloon valvuloplasty?
Usually children and elderly who are not candidates for surgical options
What is the typical symptoms of Quadracuspid AV?
Palpitations, chest pain, dyspnea, syncope
Quadracuspid atrioventricular valve is an uncommon heart defect that rarely presents with stenosis.
Quadracuspid AV is almost always associated with which condition?
AR (Aortic Regurgitation)
This association highlights the clinical significance of Quadracuspid AV in cardiac assessments.
What percentage of all valve replacements for aortic stenosis (AS) are due to Bicuspid Aortic Valve (BAV)?
50%
What percentage of all births is affected by Bicuspid Aortic Valve (BAV)?
2%
What shape is the opening of a Bicuspid Aortic Valve typically described as?
Football shaped
What change occurs to the leaflets of a Bicuspid Aortic Valve with aging?
Prone to thickening
What characteristic is seen in the systolic phase of a Bicuspid Aortic Valve in the PLAX view?
Systolic ‘doming’
What is the term used to describe the seam in a Bicuspid Aortic Valve?
Raphe
What is a challenge of 2D planimetry in severe cases?
severe Ca++ due to shadowing and poor 2D resolution
What does Ca++ refer to in this context?
Calcium
True or False: 2D planimetry is always reliable regardless of the severity of the condition.
False
What does AVA stand for?
Aortic Valve Area
What is the equation for calculating Aortic Valve Area (AVA)?
0.785 x LVOT Dia^2 x V1 / V2
What are the three measurements needed to calculate AVA?
- LVOT diameter
- PW Doppler peak velocity at the site of the LVOT diameter (V1)
- CW peak velocity across the AV (V2)
What is V1 in the context of the AVA calculation?
PW Doppler peak velocity at the site of the LVOT diameter
What does V2 represent in the AVA calculation?
CW peak velocity across the AV
What is the peak velocity range for mild aortic stenosis?
2.6-2.9 m/s
Mild aortic stenosis is characterized by a peak velocity of 2.6-2.9 m/s.
What is the mean gradient in mmHg for moderate aortic stenosis?
20-40 mmHg
Moderate aortic stenosis has a mean gradient ranging from 20 to 40 mmHg.
What is the indexed AVA for severe aortic stenosis?
<0.6 cm²/m²
Severe aortic stenosis is defined by an indexed AVA of less than 0.6 cm²/m².
What peak velocity defines severe aortic stenosis?
≥4.0 m/s
Severe aortic stenosis is indicated by a peak velocity of 4.0 m/s or greater.
Fill in the blank: The mean gradient for severe aortic stenosis is _______ mmHg.
≥40 mmHg
Severe aortic stenosis is indicated by a mean gradient of 40 mmHg or more.
What is the AVA for moderate aortic stenosis?
1.0-1.5 cm²
Moderate aortic stenosis is defined by an AVA between 1.0 and 1.5 cm².
What is the mandatory probe for AS?
PEDOF Probe
PEDOF stands for Pulsed Echo Doppler Flow Velocity Meter, which is used for assessing aortic stenosis.
What type of probe is the PEDOF probe?
Blind probe
A blind probe does not provide imaging capabilities.
What is the frequency of the PEDOF probe?
225 Hz
This frequency is used for Doppler measurements.
What does AV VTI stand for?
Aortic Valve Velocity Time Integral
This measurement is used to assess the effective area of the aortic valve.
Fill in the blank: The PEDOF probe is mandatory for _______.
Aortic Stenosis
Aortic stenosis is a condition that requires assessment of blood flow through the aortic valve.
