Aortic Valve Disease Flashcards
what is the classic triad of symptoms for aortic stenosis?
angina
dyspnea
syncope
what is the most common form of aortic stenosis?
valvular
what is the normal aortic valve area?
3-4 cm squared
at what valve area is aortic stenosis defined as critical?
< 0.7 cm squared
what ventricular problem does aortic stenosis lead to?
increased wall stress and LVH
what are the survival rates for patients with angina, syncope and heart failure with AS?
angina is 5 years
syncope is 3 years
HF is 2 years
does intensity of AS murmur correlate with severity?
no
at what valve area is aortic stenosis considered mild?
> 1.5 cm squared
at what valve area is aortic stenosis considered moderate?
1-1.5 cm squared
at what valve area is aortic stenosis considered severe?
< 1 cm squred
what is pulsus parvus et tardus?
delayed and diminished carotid pulse from aortic stenosis
is medical therapy effective for severe symptomatic AS?
no
what are the goals for medical treatment in a patient with asymptomatic AS?
prevent CAD
maintain sinus rhythm
good BP control
what patient population is a percutaneous aortic balloon valvuloplasty good for?
pediatrics with noncalcific AS, it normally lasts 10 years
in adults, restenosis often occurs within 6 months
what does TAVR stand for?
transcatheter aortic valve replacement
what is the most common cause of aortic stenosis?
age related calcification
what is the treatment of choice for a patient with symptomatic aortic stenosis?
aortic valve replacement
what is the classic murmur for aortic regurgitation?
soft blowing decrescendo murmur at LUSB
what treatment is absolutely contraindicated in aortic regurgitation?
intra-aortic balloon pump
while waiting for surgery, what two treatments can be done for a patient with aortic regurgitation?
inotropic and afterload reduction
if a patient has chest pain with aortic regurgitation, what should you think of
aortic dissection
what are two causes of chronic aortic regurgitation?
rheumatic heart disease
congenital bicuspid aortic valve
does aortic regurgitation cause volume, or pressure overload?
volume overload
what is the best determinant of postoperative left ventricular function?
left ventricular end systolic dimension (LVESD)
what LVESD predicts poor prognosis postoperatively?
> 55 mm
what is the main physical sign of aortic regurgitation?
increased pulse pressure
what is DeMusset’s sign?
head bob with each heartbeat
what is Traube’s sign?
pistol shot sound heard over femoral arteries
what is Muller’s sign?
systolic pulsation of the uvula
what is Quincke’s sign?
capillary pulsations visible in luluna
what is Hill’s sign?
popliteal cuff systolic pressure > brachial cuff systolic pressure more than 60 mmHg
when listening to a murmur from AR, what determines the severity of the regurg?
duration of the murmur
in what patient populations would you use a bioprosthetic valve?
elderly
females of child-bearing age
