Aortic Stenosis Flashcards
(30 cards)
What are the clinical features of symptomatic aortic stenosis?
Chest pain, dyspnoea, syncope/presyncope, murmur
Syncope or presyncope may present as exertional dizziness.
What type of murmur is classically seen in aortic stenosis?
Ejection systolic murmur (ESM)
This murmur classically radiates to the carotids.
How does the Valsalva manoeuvre affect the murmur in aortic stenosis?
Decreases the intensity of the murmur
What are the features of severe aortic stenosis?
Narrow pulse pressure, slow rising pulse, delayed ESM, soft/absent S2, S4, thrill, duration of murmur, left ventricular hypertrophy or failure
What is the most common cause of aortic stenosis in patients over 65 years?
Degenerative calcification
What is the most common cause of aortic stenosis in patients under 65 years?
Bicuspid aortic valve
Name a genetic condition associated with supravalvular aortic stenosis.
William’s syndrome
What are the management steps for asymptomatic aortic stenosis?
Observe the patient
What is the management approach for symptomatic aortic stenosis?
Valve replacement
When should surgery be considered for asymptomatic patients with aortic stenosis?
If valvular gradient > 40 mmHg and features such as left ventricular systolic dysfunction are present
What is the treatment of choice for young patients with low/medium operative risk?
Surgical aortic valve replacement (AVR)
What is transcatheter AVR (TAVR) used for?
Patients with high operative risk
What is balloon valvuloplasty and when is it used in children?
A procedure for patients with no aortic valve calcification
In adults, when is balloon valvuloplasty limited to?
Patients with critical aortic stenosis who are not fit for valve replacement
What are the clinical features of symptomatic aortic stenosis?
Chest pain, dyspnoea, syncope/presyncope, murmur
Syncope or presyncope may present as exertional dizziness.
What type of murmur is classically seen in aortic stenosis?
Ejection systolic murmur (ESM)
This murmur classically radiates to the carotids.
How does the Valsalva manoeuvre affect the murmur in aortic stenosis?
Decreases the intensity of the murmur
What are the features of severe aortic stenosis?
Narrow pulse pressure, slow rising pulse, delayed ESM, soft/absent S2, S4, thrill, duration of murmur, left ventricular hypertrophy or failure
What is the most common cause of aortic stenosis in patients over 65 years?
Degenerative calcification
What is the most common cause of aortic stenosis in patients under 65 years?
Bicuspid aortic valve
Name a genetic condition associated with supravalvular aortic stenosis.
William’s syndrome
What are the management steps for asymptomatic aortic stenosis?
Observe the patient
What is the management approach for symptomatic aortic stenosis?
Valve replacement
When should surgery be considered for asymptomatic patients with aortic stenosis?
If valvular gradient > 40 mmHg and features such as left ventricular systolic dysfunction are present
