Aortic Stenosis Flashcards Preview

Year 3 Rapid Medicine Cardiology > Aortic Stenosis > Flashcards

Flashcards in Aortic Stenosis Deck (16)
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1

What is aortic stenosis?

Narrowing of the left ventricular outflow at the level of the aortic valve

2

What are the 3 causes of aortic stenosis?

1 - stenosis secondary to rheumatic heart disease (commonest)

2 - calcification of a congenital bicuspid aortic valve

3 - calcification/degeneration of a tricuspid aortic valve in the elderly

3

Epidemiology summary of aortic stenosis? (3)

- ~3% of 75 y/o
- affects males more than females
- those with bicuspid aortic valves may present earlier

4

Presentation of aortic stenosis?

May be asymptomatic initially
- angina (due to increased O2 demand of hypertrophied ventricles)
- syncope/dizziness on exercise
- symptoms of heart failure

5

Examination findings in aortic stenosis?

BP - narrow pulse pressure
Pulse - slow-rising
Palpation - thrill in aortic area, forceful sustained thrusting UNdisplaced apex beat
Auscultation - harsh ejection systolic murmur at aortic area, may radiate to carotid artery + apex

6

BP sign of aortic stenosis on examination?

Narrow pulse pressure

7

Pulse sign of aortic stenosis (and regurgitation) on examination?

Slow-rising pulse
- pulsus tardus - slow-rising/falling = stenosis
- pulsus celer - fast-rising/falling = regurgitation

8

Palpation signs of aortic stenosis on examination?

- thrill in aortic area (if severe)
- forceful sustained thrusting undisplaced apex beat

9

Auscultation signs of aortic stenosis on examination?

Harsh ejection systolic murmur at aortic area
- may radiate to carotid artery and apex

Second heart sound may be softened/absent (due to calcification)

10

What sound might a bicuspid aortic valve produce on auscultation?

An ejection click

11

Investigations indicated in aortic stenosis?

ECG
CXR
Echocardiogram
Cardiac angiography

12

Signs of aortic stenosis on ECG?

- Signs of left ventricular hypertrophy (deep S wave V1-2, tall R wave V5-6, inverted T wave I/V5-6/aVL, left axis deviation)
- LBBB

13

Signs of aortic stenosis on CXR?

- Post-stenotic enlargement of the ascending aorta
- Calcification of aortic valve

14

Use of echocardiogram in aortic stenosis?

- visualises structural changes of the valves and level of stenosis
- estimates aortic valve area and pressure gradient across the valve in systole
- assesses left ventricular function

15

3 levels of valve stenosis?

Valvar, supravalvar, subvalvar

16

Use of cardiac angiography in aortic stenosis?

- allows differentiation from other causes of angina
- assesses for concomitant coronary artery disease (50% of severe aortic stenosis cases also have significant coronary artery disease)