Aortic Stenosis Flashcards
1
Q
What can be heard on auscultation of aortic stenosis?
A
- A - A2 quiet of S2
2
Q
What can be felt on examination of the heart in aortic stenosis?
A
- Right ventricular heave
3
Q
What effect does aortic stenosis have on the apex?
A
- Causes it to be constantly vigorous
4
Q
What does aortic stenosis lead to?
A
- Increased left ventricular systolic pressure
5
Q
What does increased left ventricular pressure lead to?
A
- Concentric hypertrophy
- Left heart megaly
6
Q
What will occur if the left ventricle is ischaemic combined with it’s increased size?
A
- Left ventricular failure
7
Q
Where does the systolic murmur radiate to in aortic stenosis?
A
- Radiates to carotids
8
Q
Symptoms?
A
- Long asymptomatic phase
- Cardinal signs
- Dyspnoea on exertion
- Heart failure
- Syncope and presyncope
- Chest pain
9
Q
Signs?
A
Pulses
- Small volume
- Slow rising pulse
- JVP prominent in RH failure
- Vigorous apex beat
- Right ventricular heave
- Quiet A2 of heart sound 2
- Harsh ejection systolic murmur radiating to carotids
10
Q
Causes?
A
- Degenerative
- Linked to atherosclerosis
- Slow inflammatory process
- Rheumatic
- Bicuspid valve
11
Q
What does the slow inflammatory process result in?
A
- Thickening and calcification of aortic valve cusps
12
Q
Initial investigations?
A
- ECG
- CxR
- Cardiac catheterisation
- Echocardiogram
- CMRI
- Biochemical screen
- FBC
13
Q
What will be seen on the ECG?
A
- ST/T changes
14
Q
What do the ST/T changes on the ECG point to?
A
- LV strain
15
Q
What will be seen on the CxR?
A
- Calcification of the valve
- Left heart megaly
16
Q
What will the echocardiogram show?
A
- AV cusp mobility
- LV function and hypertrophy
- Doppler assessment will show pressure gradient
17
Q
What is tested in the biochemical screen?
A
- Thyroid function
18
Q
Surgical options?
A
- Aortic valve replacement or repair
