Aortic valve disease Flashcards

1
Q

What is aortic stenosis

A

refers to narrowing of aortic valve orifice

aortic sclerosis is preclinical phase to aortic stenosis

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2
Q

What is the epidemiology of aortic stenosis

A

3rd most common CVD

prevalence increases with age

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3
Q

What are causes of aortic stenosis

A

degenerative calcification - due to age- common in older patients

bicuspid aortic valve - common in younger patients

williams syndrome

post rheumatic heart disease - mostly in developing world

subvalvular- hypertrophic obstructive cardiomyopathy

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4
Q

What may someone with aortic stenosis present with ?

A

classic triad of SAD symptoms on exertion-
Syncope
Angina
Dyspnoea

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5
Q

What findings may be found on examination in someone with aortic stenosis

A

EJECTION SYSTOLIC MURMUR
radiates to carotids
decreased following Valsalva maneuver

slow rising and delayed pulse
narrow pulse pressure

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6
Q

What investigations are required for aortic stenosis

A
  1. obtain an echocardiogram
  2. ECG
  3. consider cardiac MRI and cardiac catheterisation
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7
Q

What is management for AS if patient is asymptomatic

A

observe

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8
Q

Management for patient with AS if symptomatic

A

valve replacement

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9
Q

Management for patient with AS if asymptomatic but LVEF<50% and valvular gradient >40mmHg

A

consider surgery

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10
Q

What are the options of aortic valve replacement

A

surgical AVR treatment for young , low operative risk patients

Transcatheter AVR - for patients with high operative risk

balloon valvuloplasty
- children with no calcification/adults not fit for surgery

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11
Q

What does a patient who has had a mechanical valve also need

A

anticoagulation therapy

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12
Q

What is aortic regurgitation

A

leaking of aortic valve of heart which causes blood to flow in reverse direction during ventricular diastole

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13
Q

What can acute AR be caused by

A

infective endocarditis
aortic dissection/chest trauma

SURGICAL EMERGENCY

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14
Q

What can cause chronic AR

A

rheumatic heart disease
congenital anomalies- bicuspid aortic valve

connective tissue disorder- Marfans, Ehlers-danlos syndrome

RA

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15
Q

What may someone with AR present with

A

mild AR may be asymptomatic

  • fatigue
    -SOB
    -chest pain
    -fainting
    -swelling of ankles and feet
    -heart palpitations
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16
Q

What may be seen on examination in a patient with AR

A

EARLY DIASTOLIC MURMUR
collapsing pulse
wide pulse pressure

mid-diastolic austin flint murmur in severe AR

17
Q

What other signs are associated in a patient with severe AR

A

Corrigan sign - carotid pulsation

De musset sign - head nodding with each heartbeat

Quincke sign - capillary pulsation in nail beds

Duroziez sign - diastolic femoral murmur

Traube sign - pistol shot sound auscultated over femoral arteries

18
Q

What investigations are required for a patient with AR

A

1, echocardiogram
2. ECG or CXR
3. consider cardiac catheterisation

19
Q

What is medical management of AR

A

treatment of HTN recommended in all

beta blockers
ACEI

symptomatic patients require surgery

20
Q

What is surgical treatment for AR

A

aortic valve replacement

21
Q
A