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cardiovascular > aortic stenosis > Flashcards

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

A

carotids

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
Q

treatment for patients with BAV and enlarged ascending aorta

A

surgical intervention

26
Q

what is prognosis once symptoms occur

A

poor

2-3 years

27
Q

what is seen on CXR

A
  • small heart
  • dilated aorta
  • aortic valve calcified
28
Q

what can rheumatic fever produce

A

progressive fusion, thickening and calcification of the aortic valve

29
Q

risk factors for CAVD

A
  • old age
  • men
  • elevated lipoprotein and LDL
  • hypertension
  • diabetets
  • smoking
30
Q

what is supravalvular obstruction associated with (2)

A
  • mental retardation

- hypercalcaemia

31
Q

what is bicuspid aortic valve associated with

A
  • aortic coarctation
  • root dilatation
  • aortic dissection
32
Q

treatment for asymptomatic patients

A

regular review for assessment
and
echo

33
Q

what is done for diagnosis

A
  • CXR
  • ECG
  • echo
  • cardiac catheterisation
34
Q

what is a novel treatment for patients unsuitable for surgical replacement

A

transcatheter implantation with a balloon expandable stent valve

35
Q

who usually gets CAVD

A

elderly

36
Q

what else is associated with rheumatic fever

A

mitral valve disease

37
Q

what does it produce

A

obstruction to the left ventricular stroke volume

38
Q

what does obstructed left ventricular emptying lead to

A

increased left ventricular pressure and compensatory left ventricular hypertrophy

39
Q

what does left ventricular hypertrophy lead to

A

ischaemia of the left ventricular myocardium

  • angina
  • arrhythmias
  • left ventricular failure
40
Q

what is seen on ECG

A
  • left ventricular hypertrophy
  • left atrial delay
  • arrhythmias may be present

cardiovascular (36 decks)

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