aortic valve disease Flashcards
causes of AORTIC stenosis?
rheumatic fever(most common) calcified age related senile congenital bicusp valve sle and severe familial hypercholestermia
clinical symptoms of AS?
angina pain most common syncope chf most serious worse prognosis hemolytic anemia sudden death
heyde’s syndrome?
angiodysplasia, coagulopathy, hemolytic anemia
on examination?
apex beat not shifted soft S2 inaudible A2 splitting A2 prominent 4th heart sound pulse slow rising(pulus parvus at tardus) pulse pressure narrow cresendo decrescendo ejection systolic murmur
anacrotic pulse?
carotid pulse is slow rising and low volume
candidate of VRT?
syncope, angina and heart failure
treatment?
AVR is the treatment of choice.
medical: angina relive only by beta blockers
nitrates ace inhibitors and digoxin is contraindicated
etiology of AR?
rheumatic fever infective endocarditis most common infective cause long standing HTN aortic dissection chronic rheumatic fever takayasu arteritis syphilis
cause of acute AR?
acute rheumatic fever infective endocarditis dissection of aorta raptured sinus of valsalva aneurysm failure of prosthetic heart valve
symptoms of AR?
mild AR: asymptomatic and palpitations( due to forceful left ventricular contraction to maintain the cardiac output
severe AR: angina and dyspnea
examination finding?
prominent pulsation over pericardium apex beat shifted outside heaving beat diastolic thrill left sternal boarder soft S1 A2 may be soft or absent P2 obscured by diastolic thrill S4 often audible early diastolic murmur
what is austin flint murmur?
mid diastolic murmur when blood regurgitate into the left ventricle and push the anterior leaflet of mitral valve and cause functional mitral stenosis
other pulse signs?
de musset's sign pistol shot femoral durozier's sign quincke's sign corrigen's sign wide pulse pressure
