Valvular Heart Disease: Aortic Stenosis

Question 1

Aortic Stenosis:
Cardiac Output:
Effect on Ventricular Pumping:

Answer 1

Aortic Stenosis:
Cardiac Output: Reduced
Effect on Ventricular Pumping: Increased Effort

Question 2

Aortic Stenosis: Causes:
RHD
CBV
D

Answer 2

Aortic Stenosis: Causes:
Rheumatic Heart Disease
Congenital Bicuspid Valve - most common in under 65yrs
Degenerative (Calcification) - most common in over 65yrs

Question 3

Aortic Stenosis Symptoms: 
ECP
EB/D
ES/PS
HF
(Palpitations, Angina, reduced EET)

Answer 3

Aortic Stenosis Symptoms: 
Exertional Chest Pain
Exertional Breathlessness/Dyspnoea 
Exertional Syncope/Pre-Syncope
Heart Failure
(Palpitations, Angina, reduced EET)

Question 4

Aortic Stenosis Clinical Examination: 
CP
AB
Asc - M
Asc - HS
RV-Hv
JVP

Answer 4

Aortic Stenosis Clinical Examination:
Carotid Pulse - small volume & slow rising
Apex Beat - vigorous & sustained (non-displaced)
Auscultation M - Ej systolic Murmur (Crescendo-Decrescendo) - radiating to carotids
Auscultation HS - Heart Sounds S1 & S2 normal, less audible A2 - reduced intensity of second heart sound.
RV-Heave
JVP - prominent if Right Heart Failure

Question 5

Aortic Stenosis Investigations: 
C
C
C
E
E

Answer 5

Aortic Stenosis Investigations: 
Cardiac Magnetic Resonance
Cardiac Catheterisation
Chest X Ray
ECG
Echocardiogram

Question 6

Aortic Stenosis Treatment: 
R
R
BV
O

Answer 6

Aortic Stenosis Treatment: 
Repair valve  - if symptomatic 
Replace valve - if symptomatic 
Balloon Vavuloplasty - limited to patients with critic aortic stenosis who are not fit for valve replacement
Observe if asymptomatic