Flashcards in 22. Aortic valve stenosis - etiology, pathophysiology, physical examination, diagnosis and management. Deck (6):
what is the aetiology of aortic valve stenosis ?
congenital - bicuspid - more prone to hemodynamic stress causig progressive fibrosis and calcification of valves
degenerative - senile calcification of valves
postrheumatic - fusion of leaflets due to scarring of the valves
and then calcification after fusion of the valves
what are the main paramteres that is changed in aortic valve stenosis
aortic valve area is under 3.0cm2
what are the symptoms of aortic stenosis ?
reduced physcal capacity - dyspnea
angina pectoris - without coronary artery alteration
syncope - due to low cerebral perfusion - in severe cases
palpitation - ventricular ectopic areas
in physical exam what do you find in aortic stenosis ?
aortic valve area murmur and at the carotid arteries
crescendo decrescedno - the alter the pea th more serve the aortic stenosis is
first an ejection click after S1
can hear a pathological s4 - reduced lv compliance due to hypertrophy , atria has to squeeze harder
pulse tardus and parvus - weak and delayed
what is the diagnosis of aortic valve stenosis ?
high flow velocity - more serious stenosis
determing also pressure gradient
this all with doppler effect
left ventricular concentric hypertrophy - increase in amplitude of QRS in the left precordial leads
left bundle branch block can occur
T wave inversion and st segment depression , st depression - ischemia
left atria enlargment - volume overload - negative p wave - in extreme amount of cases
x ray -
hypertrophy of the heart
prominent aortic arch
lateral x ray - may show calcification