Aortic Stenosis

Question 1

What are the anatomical structures affected by aortic stenosis?

Answer 1

Aortic valve (left ventricle)

Question 2

What happens to the aortic valve in aortic stenosis?

Answer 2

EITHER:
1) the valve has 2 cusps rather than 3

2) the valve becomes calcified which causes it to become stenosed (narrow)

Question 3

How does aortic valve stenosis affect the heart physiology?

Answer 3

The left ventricle has to generate more force which causes hypertrophy. The ventricle becomes thicker.

This is an example of ‘pressure overload’

Question 4

Who usually gets aortic stenosis?

Answer 4

Makes over 65

Question 5

What are the SYMPTOMS of aortic stenosis

Answer 5

Angina

Breathless and light headed when exercising.

Question 6

What are the SIGNS

Answer 6

Harsh and loud ejection systolic heart murmurs heard on the top right of the heart.

Reduce pulse pressure (110/90)

Forceful apex beat felt in the 5th intercostal space.

Question 7

What are the test results

Answer 7

ECG has a larger QRS wave (bc thicker ventricle)

Echocardiogram (ultrasound) shows thick ventricle and narrowed aortic valve.

Question 8

How to treat?

Answer 8

If the left ventricle starts to dilate = surgery.

Aortic valve can be replaced via AVR using either metal/plastic valves or pig valves.

Patients with artificial valves need warfarin.