Aortic Stenosis Flashcards
What is the normal aortic valve area ?
Normal 4-5
Mild >1.5
Moderate 1-1.5
Severe <1
What is the pathophysiology of Aortic Stenosis?
- When the cross sectional area of the aortic valve is reduced by more than 50%, a pressure gradient occurs.
- Increased flow velocity through the narrowed valve causes turbulence and results in a murmur.
How will the pressure gradient effect the Left ventricle?
Increased pressure work of the LV results in concentric hypertrophy
What are the complications with LV concentric hypertrophy?
- Decreased diastolic compliance
- Inability of microciruclation to keep up with muscle growth
- Myocardial failure
Why do these pts have a decreased LV compliance?
- Increased LV end diastolic pressure
2. Increased LA pressure
Symptoms of Aortic Stenosis
- Angina Pectoris
- Syncope
- CHF
- A-fib
Describe Calcified Aortic Stenosis
- Most common valve abnormality
- HEAPED UP; calcified nodules of valve cusps.
- Do not involve commissures/cusp margins
- Extends into sinus of Valsalva
- Asymptomatic = Excellent prognosis
Physical Exam findings of Aortic Stenosis
- Systolic thrill that radiates to the carotids
2. Systolic murmur
Discuss the systolic murmur in Aortic Stenosis
Later the peak, more advanced the disease
What would suggest Aortic Sclerosis rather than Stenosis?
- Early peaking systolic ejection murmur with normal splitting of S2.
- Lack of carotid radiation or thrill
- No symptoms
- Normal apical impulse
EKG findings
LVH
Chest xray findings
- Post stenotic dialation
2. NORMAL cardiac size because LVH is concentric
Treatment of Aortic Stenosis
Severe Aortic Stenosis requires surgical intervention because of the high mortality rate if untreated
