AS

Question 1

AS symptoms

Answer 1

• exertional chest pain (50% no CAD)

* exertional dyspnea and exertional syncope

Question 2

AS signs

Answer 2

• usually nothing remarkable

Question 3

AS pulse

Answer 3

• plateau pulse (anacrotic)

* OR late peaking and low volume (tardus et parvus)

Question 4

AS JVP

Answer 4

• n/a

Question 5

AS palpation

Answer 5

• hyperdynamic apex beat
• may be slightly displaced
• systolic thrill at base of heart (in aortic area)

Question 6

AS auscultation

Answer 6

• T/C - harsh (mid)systolic ejection murmur, crescendo - decrescendo
• R - maximal over aortic area and extending into carotids, may extend widely over precordium and extend to apex
• narrowly split or reversed S2 - delayed LV ejection

Question 7

AS accentuation manouvres

Answer 7

• sitting up and in full expiration

* note - associated aortic regurg is common

Question 8

AS causes

Answer 8

• degenerative calcific aortic stenosis - elderly
• calcific in younger patients - congenital bicuspid valve
• rheumatic