Aortic Valve Disease Flashcards
What are the Etiologies of Aortic Regurg?
Valvular: congenital bicuspid valve(most common) Aging generation rheumatic fever endocarditis degeneration of bioprosthesis (pig valve) Aortic root dilation or injury: Trauma Marfan's Annuloaortic ectasia
What are the hemodynamics of Aortic regurg
LV ejected blood regurgitates
increased LVEDV increased LVEDP = LV hypertrophy and eventual LV dilation
Marked LV Hyp (cor bovinum)
LV dilation and failure
What are history findings in Aortic Regurg?
History of underlying disease
Asymptomatic until LV dysfunction begins
DYSPNEA 2ndary to CHF
What are findings in Physical Examination?
Wide pulse pressure up to 100 mmHg LV apex diffuse hyperdynamic displaced left and down S3 common with LV dysfunction aortic ejecton sounds frequent Korotkoff sounds persist to zero
What are the murmurs heard in Aortic Regurg?
Diastolic, decrescendo, blowing or musical at 2nd RICS, heard sitting forward, full expiration
Longer murmur is worse
Austin Flint murmur
Know ALL IN PPT!
What are the electrocardiogrphy findings of Aortic Regurg?
Not specific or sensitive LVH Left axis ST-T changes LA enlargement AV conduction abn
What will X rays show in Aortic Regurg?
Calcifications of Aortic root/cups Dilation/calcification of aortic root and arch Marked cardiomegaly Pulmonary Congestion Nuclear Imaging
What is seen on electrocardiography on Aortic Regurg?
.
What is the Tx of AR?
Long clinical course
Good prognosis
echo q12-24 months
Avoid vigorous sports or heavy exertion
What are the Pharm Tx of AR?
.
What are the considerations of Valve replacement in for Aortic Regurg
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What are the contraindications for Valve replacement in AR?
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What is the Pathophysiology of Aortic Stenosis?
Hemodynamics: Obstruction to outflow = Pressure gradient across the valve
Increased wall stress
Symptoms start when valve opening is
What is the Tx for Atrial Stenosis?
Surgery
What are the clinical manifestations of Aortic Stenosis?
Angina Pectorus
Syncope
GI BLEEDING
Heart Failure
