cardio: Pulmonary and aortic stenosis

Question 1

Pulmonary stenosis symtoms?

Stethescope?

Answer 1

Asymptomatic in mild stenosis, in moderate and severe exertional dyspnoea and fatigue

Ejection systolic murmur upper left sternal border with radiation to back

Ejection systolic murmur heard loudest at the pulmonary area (second intercostal space, left sternal boarder)
Palpable thrill in the pulmonary area
Right ventricular heave due to right ventricular hypertrophy
Raised JVP with giant a waves

Question 2

aortic stenosis symptoms?

Stethescope?

Answer 2

Mostly asymptomatic, if severe,reduced exercise tolerance, exertional chest pain, syncope

Ejection systolic murmur upper right sternal border, radiation into carotids

Ejection click just before the murmur
Palpable thrill during systole
Slow rising pulse and narrow pulse pressure

Question 3

investigation for stenosis?

Answer 3

ECHO

Question 4

managment of pulmonary stenosis

Answer 4

If the patient is symptomatic or the valve is more significantly stenosed, balloon valvuloplasty via a venous catheter is the treatment of choice

Question 5

management of aortic stenosis

Answer 5

Percutaneous balloon aortic valvoplasty
Surgical aortic valvotomy
Valve replacement

Question 6

complications of aortic stenosis

Answer 6

Left ventricular outflow tract obstruction