Aortic Stenosis Flashcards
What is aortic stenosis?
Inadequate opening of the aortic valve during systole
What may cause AS?
- Age-related calcification
- Rheumatic heart disease
- Congenital e.g. coarctation of the aorta, bicuspid valve
- Hypertrophic cardiomyopathy
Who is more at risk of age-related calcification of valves?
- Diabetics
- Smokers
- Hypercholesterolaemia
- Males
What organism causes rheumatic heart disease?
Group A beta-haemolytic strep (Strep pyogenes)
What other problem presents in rheumatic fever?
Arthritis (80% of cases)
What is the triad of AS?
On exhertion
- Angina
- Dyspnoea
- Syncope
How does AS present?
- Triad of AS (Dyspnoea, Syncope, Angina)
- Palpitations
- Fatigue
What murmur is heard and where?
- Crescendo-decrescendo murmur
- 2nd ICS, R sternal border
What other signs might be found in the chest?
- Aortic thrill
- Undisplaced, sustained apex beat
What happens to the pulse in AS?
- Small-volume, slow-rising pulse
- Narrow pulse pressure
What signs might you see on general examination?
Sweaty, pale, tachycardia
What is the definitive investigation for AS?
ECHO
What will an ECG show for AS?
LV Hypertrophy
- ST depression
- T wave inversion
Leads: aVL, V5, V6, I)
When would an AS be followed up?
All patients until:
- 5 cm occlusion
- Growing at a rate of 5mm a year
What surgery is offered in AS?
- Replacement
- TAVI
