aortic stenosis and regurg

Question 1

normal aortic valve area (aaa)

Answer 1

3 cm2

Question 2

aortic stenosis often leads to what type of hypertrophy?

Answer 2

pressure hypertrophy - concentric

and diastolic dysfunction

Question 3

symptoms of aortic stenosis happen when

Answer 3

demand on heart exceeds ability to increase stroke volume

Question 4

acquired aortic stenosis happens in which decade of life

Answer 4

5th decade

Question 5

congenital bicuspid valves degenerate in which decade of life

Answer 5

6th decade

Question 6

tricuspid aortic valve pathology associated with which decade of life

Answer 6

late - disorder of elderly

Question 7

exponential increase above ? % result in exponential gradient increase across aortic valve

Answer 7

50% valve orifice reduction (1.5 cm2)

Question 8

clinical manifestations of aortic stenosis

Answer 8

SAD

• syncope - exertional
• angina
• dyspnea -

Question 9

sudden death due to aortic stenosis often the result of

Answer 9

malignant tachy or brady arrythmias

Question 10

natural history of aortic stenosis

Answer 10

follow people until symptoms arise

Question 11

as the aortic stenosis gets worse - the murmur starts to peak

Answer 11

later - obliterates S2

Question 12

bicuspid aortic valve is a risk factor for

Answer 12

aortic dissection

Question 13

bicuspid aortic valve is rarely associated with

Answer 13

aortic coarctation

Question 14

majority of coarctations are in the setting of

Answer 14

bicuspid aortic valve

Question 15

Findings on ECG in aortic stenosis

Answer 15

LA enlargement and LV hypertrophy

Question 16

what happens if you give someone with aortic stenosis an ACEi - to reduce afterload -

Answer 16

can cause syncope

Question 17

aortic regurgitation associated with what 3 etiologies

Answer 17

• disease valve cusp
• diseased aortic root - CTD
• Acute pathology - dissection/endocarditis

Question 18

in acute aortic regurgitation what happens to left ventricle and left atrium

Answer 18

• left ventricle filling pressure goes up

- left atrium backs up- congestion in lungs -

Question 19

chronic aortic regurg leads to what changes in left ventricle

Answer 19

• eccentric hypertrophy
• large stroke volume
• NO pulmonary congestion

Question 20

chronic severe aortic regurg leads to

Answer 20

Systolic dysfunction

reduced ejection fraction

Question 21

in acute aortic regurgitation what happens to forward output

Answer 21

falls

Question 22

in chronic aortic regurgitation what happens to forward output

Answer 22

remains normal

Question 23

in chronic severe/decompensated aortic regurgitation what happens to forward output

Answer 23

falls- reducing stroke volume

Question 24

high pitched early diastolic murmur

• sash radiation
• associated with S3
  is. …

Answer 24

aortic regurg

Question 25

ECG on someone with aortic regurg will always show

Answer 25

LVH

see cardiomegaly on xray

Question 26

what should you avoid in medical management of aortic regurg

Answer 26

bradycardia -

Question 27

anyone who is symptomatic with aortic regurg

Answer 27

should be operated on

Question 28

if someone is asymptomatic, with normal ejection fraction but severe ventricular dilatation

Answer 28

very probably they need Sx management