Valvular heart disease I: aortic valve Flashcards
what is the most common cause of aortic regurg?
congenital bicuspid valve (usually AS/AR)
what is the pathogenesis of aortic regurg?
increased LVEDV and increased LVEDP - LV hypertrophy and eventual dilation
what history features are present in aortic regurg?
underlying disease
dyspnea (first symptom, late) - secondary to CHF
what are the classic PE findings in aortic regurg?
wide pulse pressure
murmurs (diastolic) - blowing, musical at 2nd RICS
what is an austin flint murmur?
mid to late diastolic rumble of mitral stenosis (anterior mitral leaflet prevented from full excursion by regurgitant jet in LV outflow)
what is the diagnostic test of choice for aortic regurg?
echo
what is the pharmacological treatment for aortic regurg?
reduce high systemic diastolic pressure
what drugs should be avoided in aortic regurg?
beta blockers
what are the drugs of choice for aortic regurg?
vasodilators (ACE inhibitors, dihydropyridine calcium channel blockers)
what are the clinical signs of aortic stenosis?
angina pectrois
EXERTIONAL SYNCOPE
what are the history features of aortic stenosis?
GI bleeding
heart failure
what are the PE findings of aortic stenosis?
pulsus parvus et tardus - arterial pulses are small and late
apical impulse - sustained, moves left and downward in HF
murmur - heard best at base of heart
what is the test of choice for diagnosing aortic stenosis?
echocardiography
what test is contraindicated in aortic stenosis?
stress test
