Aortic Stenosis

Question 1

What is the aetiology of aortic stenosis?

Answer 1

Degenerative - liked to atherosclerosis, slow inflammatory process, results in thickening and calcification of the cusps from the base to free margins
Rheumatic - adhesion, fusion of the commissions and retraction, stiffening of the free cusp margins
Biscuspid - aortic valve should be semilunar but some people have a bicuspid valve.

Question 2

What are the symptoms of aortic stenosis?

Answer 2

Long asymptomatic phase
Chest pain
Syncope/dizziness
Breathlessness on exertion
Heart failure

Question 3

What are the clinical presentations of aortic stenosis?

Answer 3

Pulse has small volume and slowly rises
Prominent JVP if right heart failure but low BP
Vigorous and sustained apex beat
Right ventricular heave

Question 4

What are the clinical investigations for diagnosing aortic stenosis?

Answer 4

ECG
CXR
Cardiac catheterisation
Echocardiography
Cardiac magnetic resonance

Question 5

Describe the process of the pathophysiology of aortic stenosis?

Answer 5

Increased left ventricular systolic pressure
Causes severe concentric hypertrophy and left ventricular mass
Increased left end diastolic pressure
Therefore left atrial pressure increases
Increased oxygen consumption of the mitral valve
May lead to ischemia and left ventricular failure

Question 6

what type of pulse pressure is found in someone with aortic stenosis?

Answer 6

narrow pulse pressure