Aortic Stenosis

Question 1

Aortic Stenosis- Definition

Answer 1

Narrowing of left ventricular outflow at level of aortic valve

Question 2

Aortic Stenosis- Epidemiology

Answer 2

3% of >75yo, M>F

Question 3

Aortic Stenosis- Aetiology

Answer 3

Secondary to rheumatic heart disease
Calcification of tricuspid valve in elderly
Calcification of congenital bicuspid aortic valve

Question 4

Aortic Stenosis- Symptoms

Answer 4

Asymptomatic
Angina
Syncope
Symptoms of heart failure

Question 5

Aortic Stenosis- Signs

Answer 5

BP: narrow pulse pressure
Pulse: slow rising pulse
Palpation: thrills in aortic area
Auscultation: harsh ejection systolic murmur, radiates to carotids and apex, S2 softened

Question 6

Aortic Stenosis- Investigations

Answer 6

ECG- left venticular hypertrophy, (LAD, t wave inversion in I, aVL, V5, V6) LBBB
CXR- post stenotic enlargement of ascending aorta
Echocardiogram- visualises structural changes
Cardiac angiography- differentation from other causes of angina