aortic stenosis Flashcards

1
Q

when should cardiac catheterisation be done

A

when there is a concern about concomitant mitral valve disease

before surgery

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2
Q

treatment for childhood

A

vagotomy

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3
Q

other causes of valvular stenosis

A
  • chronic kidney disease
  • Paget’s disease of bone
  • previous radiation exposure
  • systemic lupus erythematosus
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4
Q

what is murmur like

A

ejection systolic

crescendo-decresencdo

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5
Q

what is most common cause

A

calcific aortic valvular disease (CAVD)

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6
Q

what is most common form of congenital heart disease

A

bicuspid aortic valve

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7
Q

what is CAVD

A

inflammatory process involving macrophages and T lymphocytes

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8
Q

treatment for symptomatic patients

A

aortic valve replacement

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9
Q

what does it include

A
  • calcific stenosis of a trileaflet aortic valve
  • stenosis of congenitally bicuspid valve
  • rheumatic aortic stenosis
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10
Q

what may be felt in the aortic area

A

systolic thrill

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11
Q

signs

A
  • sinus rhythm
  • systolic thrill
  • apex is non-displaced
  • ejection click
  • ejection systolic murmur
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12
Q

symptoms

A
  • chest pain
  • breathlessness
  • syncope
  • pre-syncope
  • fatigue
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13
Q

who gets bicuspid aortic valve disease

A

new born babies

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14
Q

what are other causes of obstruction to left ventricular emptying

A
  • supravalvular obstruction
  • subvalvular aortic stenosis
  • hypertrophic cardiomyopathy
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15
Q

what is supravalvular obstruction

A

congenital fibrous diaphragm above the aortic valve

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16
Q

are extra heart sounds heard

A

yes S4

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17
Q

where does murmur radiate to

18
Q

what is subvalvualr aortic stenosis

A

congenital condition in which the fibrous ridge or diaphragm is situated immediately below the aortic valve

19
Q

what calcifies in CAVD

A

lipoproteins

20
Q

where is murmur best heard

A

aortic area

21
Q

what is the pulse like

A

slow-rising

22
Q

what is seen on echo

A
  • thickened, calcified aortic valve cusps
  • left ventricular hypertrophy

used to determine severity

23
Q

what is done if patient is unfit for surgery

A

balloon dilatation but results are poor

24
Q

what does calcification reduce

A

systolic opening

25
treatment for patients with BAV and enlarged ascending aorta
surgical intervention
26
what is prognosis once symptoms occur
poor 2-3 years
27
what is seen on CXR
- small heart - dilated aorta - aortic valve calcified
28
what can rheumatic fever produce
progressive fusion, thickening and calcification of the aortic valve
29
risk factors for CAVD
- old age - men - elevated lipoprotein and LDL - hypertension - diabetets - smoking
30
what is supravalvular obstruction associated with (2)
- mental retardation | - hypercalcaemia
31
what is bicuspid aortic valve associated with
- aortic coarctation - root dilatation - aortic dissection
32
treatment for asymptomatic patients
regular review for assessment and echo
33
what is done for diagnosis
- CXR - ECG - echo - cardiac catheterisation
34
what is a novel treatment for patients unsuitable for surgical replacement
transcatheter implantation with a balloon expandable stent valve
35
who usually gets CAVD
elderly
36
what else is associated with rheumatic fever
mitral valve disease
37
what does it produce
obstruction to the left ventricular stroke volume
38
what does obstructed left ventricular emptying lead to
increased left ventricular pressure and compensatory left ventricular hypertrophy
39
what does left ventricular hypertrophy lead to
ischaemia of the left ventricular myocardium - angina - arrhythmias - left ventricular failure
40
what is seen on ECG
- left ventricular hypertrophy - left atrial delay - arrhythmias may be present