Aortic Valve Disease Flashcards

1
Q

How does Aortic Stenosis lead to Heart failure?

A

Pressure backs up in the LH causing it to hypertrophy. This increases myocardial O2 deand eventually leading to LVF

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2
Q

What causes Aortic Stenosis?

A

Degenerative disease - A slowinflammatory process thickens and calciies the cusps (senile calcification, linked to atherosclerosis)
Rheumatic disease
Congenital Bicuspid Valve

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3
Q

What is the symptoms of aortic stenosis?

A

A long time is spent asymptomatic then suddenly:
Angina - Syncope - SOBOE - Heart Failure

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4
Q

What is the clinical presentation of aortic stenosis?

A

Pulse is small and slow rising
If the Right heart fails then theres a high JVP
A low BP
A vigorous & sustained Apex Beat
LV Heave
A harsh late sound in the aortic valve that radiates to the carotids (Auscultation)
Aortic Thrill

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5
Q

How do we investigate aortic stenosis?

A

ECG - CXR - Echo - CMR

ECG - LV Strain pattern showing LVH (ST depression & T inversion)

CXR - AV calcification

Echo: AV thickening - LV function - Pressure gradient with a doppler-echo

CMR - Cusp adhesion or bicuspid

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6
Q

How do we treat Aortic Stenosis?

A

We can use meds to treat heart failure
But the valve has to be surgically replaced or repaired

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7
Q

How does Aortic Regurgitation progress?

A

The blood backs up so LV volume & perssure increases -> LVH -> increased O2 demand -> Ischaemia & LV failure`

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8
Q

What can cause aortic regurgitation?

A

Dilated Aorta due to marfan’s or hypertension and connective tissue disorders.
Also congenital bicuspid AV - Rheumatic Heart Disease - Endocarditis - Myxomatous Degeneration

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9
Q

What are the symptoms of aortic regurgitation?

A

IF it happens acutely then LV failure, cyanosis and dyspnoea
If its chronic there will be a long time without symptoms with SOBOE and eventual RVF

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10
Q

What is the clinical presentation of Aortic Regurgitation?

A

A large collapsing pulse
A wide pulse pressure
A hyperdynamic & displaced Apec Beat
A soft, early diastolic murmur on auscultation of the AV.

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11
Q

What would appear in an Aortic Regurgitation ECG?

A

An LV strain pattern of ST depression & T wave inversion. Signifying LVH

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12
Q

What would show up on an Aortic Regurgitation CXR?

A

Cardiomegaly in chronic AR

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13
Q

What would an Echo show us in Aortic Regurgitation?

A

AV thickening, prolapse, bicuspid and/or vegetations.
Also LV function, dilatation & hypertrophy.
A Doppler-Echo would show the regurgitant flow.

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14
Q

How can we treat Aortic Regurgitation?

A

Vasodilator Therapy can prolong surgery but it will have to be surgically repaired or replaced eventually

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