Aortic Stenosis

Question 1

Define aortic stenosis.

Answer 1

Aortic stenosis (AS) represents obstruction of blood flow across the aortic valve due to pathological narrowing. It is a progressive disease that presents after a long subclinical period with symptoms of decreased exercise capacity, exertional chest pain (angina), syncope, and heart failure.
Can be due to aortic calcification.

Question 2

Explain the aetiology/risk factors of aortic stenosis.

Answer 2

Age >60 years
Congenitally bicuspid aortic valve
Rheumatic heart disease
Chronic kidney disease

Question 3

Summarise the epidemiology of aortic stenosis.

Answer 3

AS is the most common valvular disease in the US and Europe and is the second most frequent cause for cardiac surgery. It is largely a disease of older people, and patients typically present in the seventh or eighth decade of life.

Question 4

Recognise the presenting symptoms of aortic stenosis.

Answer 4

Dyspnoea
Chest pain
Syncope

Question 5

Recognise the signs of aortic stenosis on physical examination.

Answer 5

Ejection systolic murmur
S2 diminished and single

Question 6

Identify appropriate investigations for aortic stenosis and interpret the results.

Answer 6

Transthoracic echocardiogram (including Doppler)
ECG