Aortic Stenosis Flashcards
What is aortic stenosis?
Where the aortic valve leaflets are partly fused together giving a restrictive exit from the left ventricle
What can aortic stenosis in children often be associated with?
- Mitral valve stenosis
- Coarctation of the aorta
What is the presentation of mild to moderate aortic stenosis?
Asymptomatic murmur
What can patients with severe stenosis present with?
- Reduced exercise tolerance
- Chest pain on exertion
- Syncope
What may neonates with critical aortic stenosis present with?
Severe heart failure
What signs may be elicited on examination of a patient with aortic stenosis?
- Small volume low rising pulses
- Carotid thrill
- Murmur
- Delayed and soft aortic second sound
- Apical ejection click
Describe the murmur of aortic stenosis
Ejection systolic murmur
Where can an aortic stenosis murmur be heard loudest?
Upper right sternal edge
Where do aortic stenosis murmurs radiate to?
The neck
What investigations may be needed in aortic stenosis?
- CXR
- ECG
- Echo
What might be seen on a CXR in aortic stenosis?
- Normal or prominent LV
- Post-stenotic dilatation of the ascending aorta
What might an ECG show in aortic stenosis?
LVH
What is needed to decide when to intervene in aortic stenosis?
Regular clinical and echocardiographic assessment
What are indications for intervention for aortic stenosis?
- Symptoms on exercise
- High resting pressure gradient (>64mmHg)
What is the curative intervention in these children?
Balloon valvotomy