Heart valve problems

Question 1

Natural history of aortic stenosis

• cause
• consequence

Answer 1

calcification most common cause

LV pressure increases - causing hypertrophy, leading to a relative ischaemia (angina, arrhythmias etc)

Question 2

Congenital cause of aortic stenosis?

Answer 2

Bicuspid aortic valve - tends to be stiffer

normally aortic valve has 3 leaflets

Question 3

Symptoms of severe aortic stenosis

Answer 3

chest pain (angina type)
SOB
syncope (on exercise)
fatigue

low volume, slow rising pulse
systolic thrill @ aorta
EJECTION SYSTOLIC MURMUR RADIATING TO THE CAROTIDS

Question 4

Investigation for murmur/?heart valve problem

Answer 4

echocardiogram

Question 5

what would you expect blood pressure reading to be with aortic stenosis

Answer 5

narrow pulse pressure - small difference between systolic and diastolic

Question 6

aortic stenosis - surgical options

Answer 6

valve replacement
mechanical valve - lasts longer but thrombogenic so need anticoagulation
tissue - degenerate after 10 years but only need 3/12 anticoagulation

TAVI - transcutaneous aortic valve implantation