Aortic Valve Stenosis

Question 1

Aortic valve stenosis increased with _____

Answer 1

Age

Question 2

Etiology of:
-Aortic valve sclerosis
-Bicuspid aortic valve
-Rheumatic fever

Which is most common cause of aortic stenosis?

Answer 2

-AVS: calcification and fibrosis of aortic valve leaflets
• most common cause of aortic stenosis

-BAV: fusion of two of the three aortic-valve leaflets in utero
• patients present with symptoms of aortic stenosis earlier than in regular aortic valve calcification

-Rheumatic Fever: Rare cause of AS due to consistent use of antibiotics

Question 3

Clinical features of AS?
- Signs and symptoms
- physical examination
- Auscultation

Answer 3

• May remain asymptomatic for years

-S&S: Dyspnea, Angina, dizziness and syncope

-P.E: small BP amplitude, decreased pulse pressure; weak and delayed distal pulse (pulsus parvus et tardus)

• Ausc: Harsh crescendo-decrescendo, late systolic ejection murmur that radiates bilaterally to the carotids.
  • Hand grip decreases the intensity of the murmur
  • Soft S2, S4 best heard at apex, early systolic ejection click

Question 4

Diagnostic tests to perform on someone with suspected Aortic stenosis?

Answer 4

TTE, EKG, lab studies, CXR

Question 5

Treatment of aortic stenosis

Answer 5

Manage comorbidities: HTN, hyperlipidemia, and if severe enough, surgery