Aortic valve disease Flashcards
Most common valve disease
Aortic stenosis
Aortic stenosis murmur
Ejection systolic high pitched murmur
Crescendo-decrescendo
Decreased following valsalva manouevre
Signs of aortic stenosis
Murmur radiates to carotid
Slow rising pulse and narrow pule pressure
Exertional syncope
Dyspnoea
Chest pain
Causes of aortic stenosis
Idiopathic age related calcification (most common >65)
Bicuspid aortic valve (most common <65)
Rheumatic heart disease
William’s syndrome
HOCM
Aortic stenosis asymptomatic management
Observe patient
Aortic stenosis symptomatic management
Valve replacement
Options for aortic valve replacement
Surgical AVR for young, low/medium operative risk patients
Transcatheter AVR for patients high operative risk
Balloon valvuloplasty use
Children with no aortic valve calcification
Adults limited to patients with critical stenosis who are not fit for valve replacement
Aortic regurgitation murmur
Early diastolic soft murmur
Hear at the apex
Signs of aortic regurgitation
Collapsing pulse
Wide pulse pressure
Quincke’s sign (nailbed pulsation)
De Musset’s sign (head bobbing)
Causes of aortic regurgitation due to valve disease
Rheumatic fever (most common cause in developing world)
Calcific valve disease
Infective endocarditis
Connective tissue diseases e.g. RA/ SLE
Bicuspid aortic valve
Causes of aortic regurgitation due to aortic root disease
Bicuspid aortic valve
Aortic dissection
Spondylarthropathies (ankylosing spondylitis)
HTN
Syphillis
Marfan’s/ EDS
Management of aortic regurgitation
Medical management of any associated HF
Aortic valve replacement if indicated
Indications for aortic valve replacement in regurgitation
Symptomatic patients with severe AR
Asymptomatic patients with severe AR who have LV systolic dysfunction
