aortic stenosis & regurgitation

Question 1

What is aortic stenosis?

Answer 1

obstruction of blood flow across the aortic valve due to narrowing

Question 2

what happens to cardiac output in aortic stenosis?

Answer 2

reduced cardiac output because blood cannot be pumped efficiently

Question 3

where do you hear the aortic valve

Answer 3

right 2nd intercostal space

Question 4

give 3 causes for aortic stenosis?

Answer 4

atheroscelrosis
calcification
rheumatic heart disease

Question 5

which is the most common cause of aoritc stenosis

Answer 5

calcification

Question 6

How does rheumatic heart disease cause aortic stenosis?

Answer 6

formation of scar tissue that then = stenosis of aortic valve

Question 7

explain the pathophysiology of calcification on aortic stenosis?

Answer 7

endocardial injury causes inflammation and the deposition of calcium on the valve. progressive calcium deposition causes stenosis

Question 8

what are the 3 classic traid of symptoms in aortic stenosis?

Answer 8

angina
syncope
heart failure

Question 9

give 4 symptoms of aortic stenosis

Answer 9

syncope
dyspnea
dizziness
angina

Question 10

what type of pulse pressure is present in aortic stenosis

Answer 10

narrow pulse pressure slow rising

Question 11

what type of murmur do you hear in aortic stenosis

Answer 11

harsh systolic ejection murmur

cresendo decresendo murmur

Question 12

where do you hear the murmur in aortic stenosis

Answer 12

right upper sternal border radiating to the neck

Question 13

what is the goldstandard diagnostic method used to diagnose aortic stenosis

Answer 13

echocardiogram

Question 14

what does echocardiogram asssess in aortic stenosis

Answer 14

the pressure gradient across the valve during systole

Question 15

what cardiac changes are present in aortic stenosis

Answer 15

LV hypertrophy

Question 16

what ECG changes would be present in aortic stenosis

Answer 16

ST depression and T wave inversion

Question 17

what are the 2 treatment methods for aortic stenosis

Answer 17

valve replacement

percutaneous vulvoplasty/dilatation

Question 18

what does S1 to S2 represent

Answer 18

systole

Question 19

what does S2 to S1 represent

Answer 19

diastole

Question 20

What does S1 represent

Answer 20

closing of the AV valve

Question 21

What does S2 represent

Answer 21

closing of the aortic and pulmonary valve

Question 22

what is aortic regurgitation

Answer 22

diastolic leakage of blood from the aorta into the ;eft ventricle

Question 23

give 4 causes of aortic regurgitation?

Answer 23

disease of the valve cusps
rheumatic heart disease
infective enodcarditis
connective disorder

Question 24

give 2 causes of disease of the valve cusps in aortic regurgitation

Answer 24

ageing

marfan syndrome

Question 25

what can happen as a result of aortic regurgitation and why

Answer 25

Lv hypertrophy due to increased preload

Question 26

give 4 symptoms of aortic regurgitation

Answer 26

palpitations 
angina 
syncope
dyspnoea 
fatigue

Question 27

What causes angina and syncope in aortic regurgitation

Answer 27

low diastolic blood pressure

Question 28

what type pf pulse would you see in oaritc regurgitation

Answer 28

wide pulse pressure

Question 29

what type of murmur would you hear in aortic regurgitation

Answer 29

high pitched early diastolic murmur

Question 30

where is the diastolic murmur best heard in aortic regurgitation

Answer 30

on the left sternal angle when the patient is facing forward and on expiration

Question 31

What ECG changes would you expect to see in aortic regurgitation

Answer 31

LV hypertrophy

Question 32

what xray chnages in the lung might you see in aortic regurgitation in HF patient and why?

Answer 32

pulmonary oedema due to back-flow of blood

Question 33

what investigation method confirms the diagnosis of aortic regurgitation?

Answer 33

echo

Question 34

what are the 2 treatments for aortic regurgitation

Answer 34

diuretics/vasodilators

surgery - valve replacement

Question 35

what is the purpose of vasodilators/diuretics in the treatment of aortic regurgitation

Answer 35

reduce preload