aortic stenosis

Question 1

aortic stenosis aetiology/risk factors

Answer 1

Senile calcification of the valve is by far the most common (80%)
can-biscupid valve, rheumatic heart disease

Nearly 25% of people ≥65 years have aortic sclerosis, and 17% progress to stenosis
Male>female

care -bicuspid valves, rheumatic fever, CKD

Question 2

aortic stenosis presentation

Answer 2

Usually asymptomatic as progress
Comes as: OLD with Chest pain and exertional dyspnea /syncope
SOB

can have : dizzy, faints

Question 3

aortic stenosis investigations

Answer 3

ECG -often abnormal-p-mitriale, LVH with strain, can get LBBB or complete block

LVH and absent Q waves helps distinguish AS from other conditions such as aortic sclerosis with ischaemic heart disease.

DIAGNOSIS-Echocardiogram shows stenosis
elevated aortic pressure gradient;

Question 4

Aortic stenosis differentials

Answer 4

Hypertrophic cardiomyopathy
–hand gripping manoeuvres, which increases afterload, will soften the HCM murmur.
Standing up after squatting -increase HCM
SHOULDNT CHANGE AS

Aortic sclerosis-like Stenosis but before its bad-S2 normal, no carotid delay. NOT IN CAROTIDS

As chest pain-

Question 5

Aortic stenosis management

Answer 5

general-
asymtomatic-observe
symptoms- replace valve

replacing can be-
for young fit pt–
Surgical AVR
High surgical risk- Transcather AVR (TAVR)

For kids or bad AS unfit for surgery- balloon valvuloplasty