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9 Cards in this Set
- Front
- Back
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Aortic Stenosis
- Clinical sx |
Slow rising, low volume pulse
Narrow pulse pressure Apex beat is Sustained in Stenosis (heaving, pressure loaded) Thrill in aortic area Auscultation: ejection systolic, loudest aortic area and radiating to carotids |
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Aortic Stenosis
- Systemic sx |
Endocarditis: splinters, Osler's nodes, Janeway lesions, Roth spots, temperature, splenomegaly, haematuria
LV dysfx: dyspnoea, displaced apex beat + bibasal crackles Acute conduction problems due to endocarditis Chronic conduction prob due to calcified AV |
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Aortic Stenosis
- Classic triad of sx |
Exertional DAD:
Dyspnoea Angina Dizziness -> syncope |
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Aortic Stenosis
- Differential diagnosis |
HOCM (gets quieter on squatting, AS louder)
VSD Aortic sclerosis (nil radiation) Aortic flow murmur |
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Aortic Stenosis
- Causes |
ABCs:
Age (senile degneration + calcification) Bicuspid Congenital abnormalities Strep associated (rheumatic fever, bacterial endo) |
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Aortic Stenosis
- Ix |
ECG: LVH, +/- conduction defect
CXR: normal +/- calcified valve Echo: gradient >50mmHg Catheter |
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Aortic Stenosis
- Tx |
Asymptomatic - none, monitor
Surgical: AV replacement +/- CABG Medical: Transcut AV implantation, transfemoral AV or balloon aortic valvuloplasty |
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Infective Endocarditis
- Duke's criteria |
Major:
Typical organism in 2 x BC Echo: abscess, vegetation Minor: Pyrexia >38C Echo suggestive Predisposed Embolic phenomena Atypical organism on BC Dx if pt has 2 major or 1 major and 2 minor or all minor |
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Infective Endocarditis
- recommendations for prophylactic antibx |
NICE 2007 - limited to those with prosthetic values, previous endocarditis, cardiac transplants w valvuloplasty, and specific congenital heart diseases.
Recommend good dental health |
