Aortic Stenosis Flashcards

1
Q

What is aortic stenosis?

A

Where the aortic valve leaflets are partly fused together giving a restrictive exit from the left ventricle

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2
Q

What can aortic stenosis in children often be associated with?

A
  • Mitral valve stenosis

- Coarctation of the aorta

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3
Q

What is the presentation of mild to moderate aortic stenosis?

A

Asymptomatic murmur

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4
Q

What can patients with severe stenosis present with?

A
  • Reduced exercise tolerance
  • Chest pain on exertion
  • Syncope
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5
Q

What may neonates with critical aortic stenosis present with?

A

Severe heart failure

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6
Q

What signs may be elicited on examination of a patient with aortic stenosis?

A
  • Small volume low rising pulses
  • Carotid thrill
  • Murmur
  • Delayed and soft aortic second sound
  • Apical ejection click
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7
Q

Describe the murmur of aortic stenosis

A

Ejection systolic murmur

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8
Q

Where can an aortic stenosis murmur be heard loudest?

A

Upper right sternal edge

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9
Q

Where do aortic stenosis murmurs radiate to?

A

The neck

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10
Q

What investigations may be needed in aortic stenosis?

A
  • CXR
  • ECG
  • Echo
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11
Q

What might be seen on a CXR in aortic stenosis?

A
  • Normal or prominent LV

- Post-stenotic dilatation of the ascending aorta

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12
Q

What might an ECG show in aortic stenosis?

A

LVH

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13
Q

What is needed to decide when to intervene in aortic stenosis?

A

Regular clinical and echocardiographic assessment

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14
Q

What are indications for intervention for aortic stenosis?

A
  • Symptoms on exercise

- High resting pressure gradient (>64mmHg)

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15
Q

What is the curative intervention in these children?

A

Balloon valvotomy

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16
Q

Who is balloon valvotomy difficult in?

A

Young children and neonates

17
Q

What do most children requiring treatment in the first few years of life later need?

A

Valve replacement

18
Q

To avoid the complications of early balloon valvotomy what do young children and neonates usually receive?

A

Palliative treatment to delay definitive intervention