aortic valve (Lite) Flashcards
Q: What are the four anatomic components of the aortic root?
“The aortic sinuses (sinuses of Valsalva)
Q: How is the aortic valve related to the aortic root anatomically and functionally?
“They form a single functional unit; the diameter of the aortic annulus is 15%-20% larger than that of the sinotubular junction
Q: What are the morphological types of calcific aortic stenosis?
“Congenitally bicuspid
Q: What is the morphology of rheumatic aortic stenosis?
“Fibrous thickening
Q: What characterizes degenerative aortic stenosis?
“Diffuse nodular calcification with a three-cusp valve and no commissural fusion.”
Q: What are the typical age ranges for different etiologies of aortic stenosis?
“Age <70: likely congenital or rheumatic; Age >70: likely degenerative.”
Q: What is the pathophysiology of severe aortic stenosis with normal cardiac output?
“There is a transvalvular gradient >50 mmHg
Q: What symptoms can occur in aortic stenosis?
“Initially asymptomatic; later: syncope and dizziness (due to cerebral hypoperfusion or arrhythmias)
Q: What are the physical examination findings in aortic stenosis?
“Small volume
Q: What ECG findings may be present in aortic stenosis?
“Left ventricular hypertrophy (LVH)
Q: What CXR findings suggest aortic stenosis?
“Left ventricular enlargement
Q: What imaging and tests are used to confirm aortic stenosis?
“Echocardiogram with Doppler
Q: What is the natural history of severe symptomatic aortic stenosis?
“High risk of sudden death.”
Q: What is the natural history of mild-to-moderate asymptomatic aortic stenosis?
“50% remain event-free for 4 years.”
Q: What is the prognosis for mild-to-moderate symptomatic aortic stenosis?
“One-third die within 4 years.”
Q: What causes syncope in aortic stenosis?
“Usually occurs with exertion due to peripheral vasodilation and the inability to increase cardiac output across the fixed stenosis
Q: How is asymptomatic aortic stenosis medically managed?
“Focus on primary prevention of ischemic heart disease
Q: What are the main medications used for symptomatic aortic stenosis?
“Vasodilators (e.g. NTG
Q: What is the curative treatment for aortic stenosis?
“Surgical valve replacement.”
Q: What is the role of endocarditis prophylaxis in aortic valve disease?
“Very important in all patients with valvular heart disease (VHD); includes maintaining good oral hygiene and aseptic techniques during catheter or invasive procedures.”
Q: What are the surgical options for aortic valve replacement?
“Mechanical valve
Q: What is balloon valvuloplasty and when is it used?
“An interventional procedure with poor outcomes and high restenosis; may be used as a bridge to surgery in hemodynamically unstable patients or those needing urgent non-cardiac surgery.”
Q: What is TAVI (Transcatheter Aortic Valve Implantation)?
“A minimally invasive interventional procedure used for selected patients with symptomatic severe aortic stenosis
Q: How often should asymptomatic severe aortic stenosis be re-evaluated?
“Every 6 months with assessment of symptoms
