Aortic stenosis

Question 1

What are the causes of aortic stenosis?

Answer 1

Atherosclerotic-like calcific degeneration.
Congenital bicuspid valve.
Rheumatic heart disease.

Question 2

What are the symptoms of aortic stenosis?

Answer 2

Syncope.
Dyspnoea.
Angina.

Question 3

What are the signs of aortic stenosis?

Answer 3

Narrow pulse pressure.

Slow rising pulse.

Question 4

Describe the murmur in aortic stenosis.

Answer 4

Crescendo-decrescendo ejection systolic murmur, which radiates to the carotids.

Question 5

What investigations should be performed for suspected aortic stenosis?

Answer 5

ECG: left ventricular hypertrophy, AV block.
CXR: poststenotic dilation of the ascending aorta, may see calcification of valve on lateral view.
ECHO: confirms diagnosis, allows severity and valve area to be assessed.

Question 6

What is the conservative treatment of aortic stenosis?

Answer 6

Manage cardiovascular risk factors, e.g. smoking cessation.

Question 7

What is the medical treatment of aortic stenosis?

Answer 7

Manage cardiovascular risk factors, e.g. control blood pressure.

Question 8

What is the surgical treatment of aortic stenosis?

Answer 8

Valve replacement is the treatment of choice.

Question 9

What are the complications of aortic stenosis?

Answer 9

Sudden death
Arrhythmia
Heart failure
Infective endocarditis