Aortic stenosis

Question 1

What is the pulse like in AS

Answer 1

Pulsus parvus et tardus
Small and slow-rising

Narrow pulse pressure

Question 2

Causes of Aortic stenosis

Answer 2

Degenerative/senile calcification
Accelerated 20 years in bicuspid aortic valve.

Rheumatic heart disease

Question 3

Aortic stenosis auscultatron

Answer 3

2nd right IC space, systolic crescendo decrescendo

Loudest on EXhalation

Extends to the carotids

Paradoxical splitting of the second sound.

Question 4

Symptoms of aortic stenosis

Answer 4

SAD
Syncope
Angina
Dyspnea

Question 5

CXR features of aortic stenosis

Answer 5

LV hypertrophy,

Post stenotic dilation of the aorta

Pulmonary congestion

Question 6

Aortic stenosis prognosis

Answer 6

Bad, requires surgery (not immediate though)

Angina - 50% death at 5 years

Syncope - 50% at 3 years

Congestive heart failure 50% in 2 years

Question 7

When is Surgery indicated for AS

Answer 7

Valve replacement is only useful surgical replacement. Baloon Valvuloplasty is NOT effective for AS, has same mortality as other treatments and high rate of restenosis.

When there is a positive stress test

When EF is less that 50%