Aortic Stenosis Flashcards
What is Aortic stenosis?
narrowing of the three cusps that form the aortic valve
What are the causes of Aortic stenosis?
- congenital - bicuspid valve, williams syndrome
- senile calcification (most common cause)
What are the signs of Aortic stenosis?
- ejection systolic murmur best heard in the aortic area, radiating to carotids.
- slow-rising pulse, with a narrow pulse pressure.
- Heave
- possible signs of heart failure / pulmonary hypertension (crackles at lung bases, pink frothy sputum, oedema)
- possible signs of AF (irregularly irregular pulse)
what are the symptoms of Aortic stenosis?
angina
syncope
dyspnoea
fatigue
what might be seen on an ECG if a patient has Aortic stenosis?
LBBB - due to calcification
Left axis deviation
left ventricular deviation
poor R wave progression
what is a doppler echo used to do in Aortic stenosis?
estimate pressure across the valve
what does a pressure of 0mmHg on a doppler echo suggest?
normal valve
what does a pressure of <30mmHg on a doppler echo suggest?
mild aortic stenosis
what does a pressure of 30-50mmHg on a doppler echo suggest?
moderate aortic stenosis
what does a pressure of >50mmHg on a doppler echo suggest?
severe aortic stenosis
what is the prognosis aortic stenosis if untreated and angina is present?
2 years
what is the prognosis aortic stenosis if untreated and syncope is present?
1 year
what is the prognosis aortic stenosis if untreated and dyspnoea is present?
6 months
when is surgery recommended for aortic stenosis?
if symptomatic
patients with ECG signs, and moderate/severe disease on doppler echo
what can cardiac catheterisation do in aortic stenosis?
assess the actual gradient across the valve as well as check for co-existing CAD
what should be done after surgery to avoid bacterial endocarditis?
patients put on antibiotics
How long do prosthetic valves last?
10 years
what is the advantage of prosthetic valves?
no need for long term anticoagulant therapy
How long do metal valves last?
lifetime
what are the disadvantages of metal valves?
require anticoagulant therapy for life. Also noisy
What are the 3 types of metal valves?
titling disc
double tilting disc
ball in a cage
