Aortic Stenosis Flashcards
1
Q
What are the clinical features of aortic stenosis?
A
Signs
- rising pulse
- heave at 4th heart sound
- plateau pulse
- narrow pulse pressure
- mid-systolic aortic murmur, radiates to neck
- BP increased (if mild), decreased (if severe)
Symptoms (“SOB”)
- syncope
- angina
- dyspnoea
- palpitations
- fatigue
2
Q
What are some causes of aortic stenosis?
A
- rheumatic heart disease (Ashkoff nodules)
- bicuspid aortic valve
- congenital heart disease
- SLE
- paget’s disease
- hypercholesterolaemia
3
Q
What investigations are there to rule out aortic stenosis?
A
Bedside
- ECG - ?LVH, LBBB
Bloods
- troponin - increased
Imaging
- CXR - ?dialted aortic arch
- Echo - ?calcified valve, decreased EF
- Doppler - ?severity of stenosis
- CT
- MRI
4
Q
what is the surgical management of aortic stenosis?
A
aortic valve replacement
5
Q
What is the difference between mechanical and bioprosthetic valve replacement?
A
Mechanical
- longer
- noisy clicks
- requireds warfarin
Bioprosthetic
- lasts approx 10-15 years
- only need to take aspirin
6
Q
What are the clinical features of Mitral stenosis?
A
Signs
- pulmonary HTN
- severe SOB
- AF
- recurrent bronchitis
- increased JVP
Symptoms
- tinged frothy sputum
- mitral facies (malar flush)
7
Q
What is this?
A
malar flush
8
Q
What are the clinical features of pulmonary stenosis?
A
Signs
- right ventricular hypertrophy
- RHF
- midsystolic murmur
9
Q
What are the clinical features of tricuspid stenosis?
A
Signs
- increased JVP
- systolic liver pulsations
- mid diastolic murmur
- hepatomegaly
- ascites
- peripheral oedema
Symptoms
- abdominal pain
- SOB
