Aortic Stenosis Flashcards
(12 cards)
How does aortic stenosis develop?
Fibrocalcific change on the tricuspid valve - most common, over 65
Bicuspid aortic valve - more common in the young - congenital causing abnormal flow pattern
What symptoms can you have from aortic stenosis
Exertional:
- presyncope or syncope
- angina chest pain
- breathless
Why does breathlessness occur in AS
- adaption to stenosed valve to push out = HYPERtrophy of left ventricle
- the muscle stiffens and causes daistolic impairment (can’t fill properly)
- this causes high LV and LA pressure
- this can eventually cause HF and cause pulmonary odema
Why can you feel lightheaded with AS
On exertion the bark receptors sense high LV pressure (due to hypertrophy
- indices arterial hypotension, decreased venous return and Bradycardia
- = syncope/presyncope
Why can you have chest discomfort and angina in AS
- LV hypertrophy = increased myocardial O2 demand
- may have concomitant coronary disease (40-80% of people with angina in AS)
- reduced perfusion and increased demand combo
What type of murmur
Crescendo-decrescendo systolic ejection murmur
EJECTION SYSTOLIC
May radiate to the carotids
Clinical signs of aortic stenosis
- radiation of ejection systolic murmur to carotids
- crepitations on lung auscultation - pulmonary oedema sign
- slow rising pulse
- palpable heave of apex beat dye to LV hypertrophy
- narrow Pulse pressure
What is the first test for diagnosing Aortic Stenosis
Transthoracic echocardiohram - accessible, severity determining
ECG cannot diagnose but may indicate LV hypertrophy etc
Cardiac catheterisation is performed before any valve operation to assess coronary arteries - may need coronary bypass etc
What is done to treat aortic stenosis
Mechanical valve for long term durability
Trans catheter aortic valve implantation
Needs warfarin for anticoagulation
What drugs are given after surgery
Warfarin
What are the death rates of Heart failure, syncope and angina if the AS goes untreated
2, 3 and 5 years
