Aortic Stenosis

Question 1

What is aortic stenosis?

Answer 1

-Narrowing of the aorta, it can occur above, below or at aortic valve

Question 2

What are the structural abnormalities of aortic stenosis?

Answer 2

• the aortic valve may be bicuspid over tricuspid from birth

- the valve becomes calcified and narrows

Question 3

What are the physiological abnormalities?

Answer 3

• left ventricular hypertrophy as more force has to be generated to eject blood through the aortic valve
• this causes a pressure overload

Question 4

How does aortic stenosis present?

Answer 4

• Frequently male patients over 65

- no symptoms for many years

Question 5

Experienced symptoms and clinical signs

Answer 5

• angina chest pain
• breathlessness with exercise
• light-headedness with exercise
• loud “ejection systolic” heart murmur at aortic valve
• reduced pulse pressure (difference of 20mmHg instead of 50mmHg between systolic and diastolic blood pressure)
• forceful apex beat

Question 6

Abnormal test results

Answer 6

• QRS on ECG (evidence of more muscular left ventricle)

- narrowed aortic valve and hypertrophied left ventricle shown on echocardiogram

Question 7

Medical/surgical intervention

Answer 7

• only observation if pressure between left ventricle and aorta is below 6mmHg
• surgery is left ventricle begins to dilate
• aortic valve replacement
• surgical valves made or metal and plastic or pig valves

Question 8

Primary and secondary prevention

Answer 8

-patients with artificial valves require life-long treatment with warfarin (anticoagulant treatment), patients with tissue valves don’t require warfarin