Aortic Stenosis

Question 1

What is aortic stenosis?

Answer 1

Narrowing of the aortic valve, causing obstruction to the flow of blood into the aorta during systole. This is a progressive disease.

Question 2

Name 4 risk factors for aortic stenosis.

Answer 2

• Age
• Congenital bicuspid valve
• Smoking
• CKD

Question 3

Name the three main causes of aortic stenosis.

Answer 3

• Age related calcification
• Congenital bicuspid valve
• Rheumatic fever (uncommon in the west)

Question 4

Name two congenital conditions in which a bicuspid valve may be seen.

Answer 4

• Turner’s syndrome

- Coarctation of the aorta

Question 5

What are the symptoms of aortic stenosis?

Answer 5

SAD:

• Syncope
• Angina
• Dyspnoea

Question 6

Name three signs of aortic stenosis.

Answer 6

• Ejection systolic murmur (crescendo-decrescendo) radiating to carotids
• Narrow pulse pressure
• Pulsus parvus et tardus (weak and slow rising)

Question 7

What investigations would you carry out in suspected aortic stenosis?

Answer 7

CXR - dilatation of the aorta, calcification of valver
ECG - absent Q waves, evidence of LVH
Echo - visualise structural changes
Doppler - measure pressure difference across valve

Question 8

Which is the diagnostic test for aortic stenosis?

Answer 8

Echo + Doppler

Question 9

How would you manage aortic stenosis?

Answer 9

Surgical - valve replacement
Non-surgical - valvoplasty (if patient not fit for surgery)
Also - prophylactic antibiotics against IE

Question 10

Name some complications of aortic stenosis

Answer 10

• Left ventricular failure
• Arrhythmia
• MI
• Sudden death

Question 11

Risk factors for age-related calcification

Answer 11

• smoking
• HTN
• hyperlipidaemia
• diabetes mellitus