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25 Cards in this Set
- Front
- Back
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What are some examples of congenital aortic stenosis?
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Different numbers of leaflets (bicuspid instead of tri)
HLHS |
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What are some examples of acquired aortic stenosis?
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Calcification of the valve, fusing of the leaflets due to calcification secondary to atherosclerotic debris
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What are some of the clinical findings in aortic stenosis?
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Dyspnea (less atrial kick; less CO)
Angina pectoris Dyspnea Diastolic dysfunction |
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What does the carotid pulse look like in aortic stenosis?
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What are the qualities of the murmur of aortic stenosis?
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Diamond shaped systolic murmur
Louder and longer duration the more severe the stenosis Radiation to the carotids |
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In what cases don't you hear a murmur from aortic stenosis?
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When CO is severely reduced - nothing's going past the valve, really. Very bad
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What is the best diagnostic modality for the diagnosis of aortic stenosis?
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Echocardiogram
Are able to see amount of flow through the valve, area of the valve, etc. |
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What's the differential diagnosis for a systolic murmur?
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VSD
Pulmonic stenosis Tricuspid regurgitation Hypertrophic obstructive cardiomyopathy Mitral regurgitation |
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Where should you auscultate for the tricuspid valve?
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4L intercostal
Augmentation occurs with inspiration |
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Where should you auscultate for the pulmonic valve?
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2 L intercostal
Augmenting with inspiration |
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Where should you auscultate for the aortic valve?
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Entire left side of the heart; heard throughout
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Where should you auscultate for a VSD?
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3rd L/R intercostal space; grade 5 murmur, normally
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What is unique about the murmur from a hypertrophic heart?
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Alters with the valsalva murmur
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What should you do when the symptoms of aortic stenosis start?
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Intervene!
There's a steep drop in survival after the onset of severe symptoms |
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What are the treatments for young patients with aortic stenosis?
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Balloon valvotomy
Ross procedure (take px. pulmonary valve+vein, put on aortic, cadaver graft to original place of aorta) |
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What problems are most common with percutaneous interventions for aortic stenosis? Surgical?
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Clotting
Atrial fibrillation |
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When auscultating, what indicates more severe aortic stenosis?
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Later peaking murmur
Louder |
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What are causes of aortic regurgitation?
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Valve abnormalities:
-Bicuspid valve -Endocarditis -Rheumatic Dilatation of aortic root: -Aortic aneurysm -Aortic dissection -Annulo-aortic ectasia -Syphilis |
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What are possible causes of acute pulmonary edema?
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Aortic dissection
Acute endocarditis |
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What is the pathophysiology of chronic aortic regurgitation?
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Hypertrophy-->dilation-->failing LV-->CHF
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What are the clinical features of aortic regurgitation?
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Palpitations
Dyspnea Fatigue ANGINA AT NIGHT!!! PATHOMNEMONIC! |
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What happens to pulse pressure as aortic regurgitation gets more severe?
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Widens!
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What is the murmur like in aortic regurgitation?
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Diamond shaped systolic murmur
Decrescendoing diastolic murmur |
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What are the features of aortic regurgitation on physical exam?
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Hyperkinetic pulse
Displaced LV apex Booming carotid Widened pulse pressure |
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What is the management for aortic regurgitation?
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Noninvasive followup
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