Aortic Stenosis Flashcards
What is Aortic stenosis?
narrowing of the three cusps that form the aortic valve
What are the causes of Aortic stenosis?
- congenital - bicuspid valve, williams syndrome
- senile calcification (most common cause)
What are the signs of Aortic stenosis?
- ejection systolic murmur best heard in the aortic area, radiating to carotids.
- slow-rising pulse, with a narrow pulse pressure.
- Heave
- possible signs of heart failure / pulmonary hypertension (crackles at lung bases, pink frothy sputum, oedema)
- possible signs of AF (irregularly irregular pulse)
what are the symptoms of Aortic stenosis?
angina
syncope
dyspnoea
fatigue
what might be seen on an ECG if a patient has Aortic stenosis?
LBBB - due to calcification
Left axis deviation
left ventricular deviation
poor R wave progression
what is a doppler echo used to do in Aortic stenosis?
estimate pressure across the valve
what does a pressure of 0mmHg on a doppler echo suggest?
normal valve
what does a pressure of <30mmHg on a doppler echo suggest?
mild aortic stenosis
what does a pressure of 30-50mmHg on a doppler echo suggest?
moderate aortic stenosis
what does a pressure of >50mmHg on a doppler echo suggest?
severe aortic stenosis
what is the prognosis aortic stenosis if untreated and angina is present?
2 years
what is the prognosis aortic stenosis if untreated and syncope is present?
1 year
what is the prognosis aortic stenosis if untreated and dyspnoea is present?
6 months
when is surgery recommended for aortic stenosis?
if symptomatic
patients with ECG signs, and moderate/severe disease on doppler echo
what can cardiac catheterisation do in aortic stenosis?
assess the actual gradient across the valve as well as check for co-existing CAD
