Week 5 - Valvular Heart Disease - Aortic Valve Flashcards
What are features of the aortic valve?
3-4cm^2. 3 cusps
What is the aetiology of aortic stenosis?
rheumatic disease or degeneration (atherosclerosis) with age. congenital (bicuspid aortic valve).
What is the most common cause of aortic valve disease?
degeneration with age
What is the pathophysiology of aortic stenosis?
LV has high pressure to push against. so muscle hypertrophy’s and has higher o2 demand. leads to ischaemia and left ventricle failure
What are the symptoms of aortic stenosis?
once symptoms begin, life expectancy drops like a stone. angina, chest pain, syncope, dizziness, heart failure symptoms
What is found upon clinical examination of aortic stenosis?
pulse slow.
low bp.
prominent JVP IF right heart failure occurs.
vigorous apex beat.
RV heave.
auscultation - normal b1 and less audible b2
How do you investigate aortic stenosis?
ECG ST-T wave changes
CXR calcification of aortic valve
echocardiography for valve view
CMR shows opening of valves and hypertrophy
What medical treatment is available for aortic stenosis?
those who develop heart failure. valve replacement
What is CMR?
cardiac magnetic resonance image. shows hypertrophy, fibrosis and valves. used for valvular issues
What is the aetiology of aortic regurgitation?
diseases of aorta - dilated aorta, tissue disorders, diseases of leaflets, bicuspid aortic valve, rheumatic heart disease or endocarditis
What is the pathophysiology of aortic regurgitation?
LV has a higher EDV, so it dilates and has higher pressure, so hypertrophy’s. higher o2 demand, ischaemia, LV failure
What are symptoms of aortic regurgitation?
chronic cases, slowly happens over decades and asymptomatic. presents with breathlesness
acute is medical emergency - wall cant adapt so medication given and surgery needed to replace/repair valve.
What is found upon clinical examination of aortic regurgitation?
- collapsing pulse
- large pulse volume. high systolic and low diastolic pressure
- apex beat hyperdynamic and displaced
- ausciltation, patient sit up and forward so heart is closest to chest wall. b1 and b2 normal, but crescendo after 2nd beat - echo
What investigations are carried out for aortic regurgitation?
ECG shows ST-T changes
CXR - very large heart - especially in chronic
Echocardiograpjy
CMR
What medical treatment is given for aortic regurgitation?
vasodilator therapy delays time for surgical innervation. given for 3-5 years. valve usually replaced, not repaired
