Aortic Stenosis Flashcards
What is it?
A tight/closed aortic valve that allows reduced blood flow into the aorta
What is the main cause?
Senile calcification
What are the other causes? (3)
Congenital Bicuspid valve, Williams Syndrome, Rheumatic Fever
Is there a precursor to this?
Yes, it is called Aortic Sclerosis when it isn’t as severe
Is aortic stenosis common?
Yes, it is the most common type of valve disease. It affects 2-7% of adults over 65
What are the risk factors?
Congenital bicuspid valve
Symptoms (4)
Chest pain, Dyspnoea, dizziness, syncope
Signs (9)
Ejection systolic murmur, systemic emboli, sudden death. slow rising pulse, heaves, non-displaced apex beat, aortic thrill, inaudible A2
What bloods would you do? (7)
FBC, U&E, LFT, CRP, BNP, Lipids, Glucose
Other investigations (8)
ECG, ECHO, Chest xray, TOE, Exercise testing, CT, Cardiac Catheterisation, Coronary Angiograpgy
What is the treatment? (6)
TAVI, avoid heavy exertion, rate control with beta blockers or digoxin, Diuretics to reduce preload, ACE inhibitors, Warfarin/NOAC
Complications (4)
Eventually leads to decompensation (heart dilates so can’t maintain output anymore) which results in congestive heart failure, damaged valves susceptible to endocarditis, calcified valves can produce emboli, sudden death <0.2% per year
Is there a good prognosis?
Sudden cardiac death is frequent in symptomatic patients, as soon as symptoms occur the prognosis is poor, survival rates are 15-20% at 5 years
