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Flashcards in Aortic Stenosis Deck (11)
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1
Q

Clinical signs of aortic stenosis

A
Slow rising pulse, low pulse volume
Narrow pulse pressure
Apex beat undisplaced (Sustained in Stenosis)
Thrill in 2nd ICS right sternal edge
Murmur
2
Q

Murmur of aortic stenosis

A

Crescendo decrescendo ESM

Heard loudest in aortic area, best during expiration and radiating to carotids

3
Q

aortic stenosis complications + signs

A

Bacterial endocarditis: Osler nodes, Janeway lesions, Roth spots, splenomegaly, fever, haematuria, splinter haemorrhages
Left ventricular dysfunction: displaced apex beat, SOB, bibasal crackles

4
Q

Differential Dx for aortic stenosis

A

Aortic sclerosis (normal pulse character and no radiation)
Aortic flow
VSD
HOCM

5
Q

Causes of aortic stenosis

A
Congenital (bicuspid)
Age (degenerative changes and calcification)
Streptococcal infection (rheumatic valve)
6
Q

Prognosis of AS based on sxs

A

Angina - 50% 5y mortality
Syncope - 50% 3y mortality
Breathlessness - 50% 2y mortality

7
Q

Echo criteria for AS severity

A

Aortic valve area:
<1cm^2 - severe
<0.8cm^2 - critical

8
Q

Mx of asymptomatic AS

A

No specific mx.
Good dental health
Regular review of sxs and echos.

9
Q

Mx of symptomatic AS

A

Surgical: aortic valve replacement +/- CABG
Percutaneous: balloon aortic valvuloplasty, transcatheter aortic valve implantation

10
Q

Dukes criteria

A
Major criteria:
Typical (HACEK) organisms in two blood cultures
Echo: abscess, dehiscence, vegetations
Minor criteria:
Pyrexia >38
Echo suggestive 
Predisposition e.g. Prosthetic valve
Embolic phenomena
Vasculitic phenomena (high CRP or ESR)
Atypical organisms on blood cultures

2 major, 1 maj and 2 minor, or 5 minor criteria.

11
Q

When do you use prophylactic Abx to prevent BE?

A

Prosthetic valves
Previous endocarditis
Cardiac transplants with valvulopathy
Some types of congenital heart disease