22. Aortic valve stenosis - etiology, pathophysiology, physical examination, diagnosis and management. Flashcards Preview

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Flashcards in 22. Aortic valve stenosis - etiology, pathophysiology, physical examination, diagnosis and management. Deck (6):
1

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

2

what are the main paramteres that is changed in aortic valve stenosis

aortic valve area is under 3.0cm2

3

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

4

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

low bp

5

what is the diagnosis of aortic valve stenosis ?

echocardiograph
high flow velocity - more serious stenosis
determing also pressure gradient
this all with doppler effect

ECG
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

6

what is the management of aortic valve stenosis ?

mechnical valve replacement

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