Module 4 Logbooks - Aortic Stenosis

Front 1

Module 4 - logbook 2: definition

Back 1

Aortic stenosis is the obstruction of blood flow across the aortic valve

Front 2

Module 4 - logbook 2: epidemeology

Back 2

2-7% of 65+ degenerative calcified stenosis. Aortic valve disease 3/1000 births. Rheumatic fever rare in Western countries

Front 3

Module 4 - logbook 2: risk factors

Back 3

Congenital bicuspid valve and age

Front 4

Module 4 - logbook 2: common presentation

Back 4

Asymptomatic for 10-20 years. shortness of breath on exertion, angina, dizziness, or syncope. Syncope may cause arrhythmia and sudden death. 'Classic triad' chest pain, heart failure and syncope

Front 5

Module 4 - logbook 2: investigations

Back 5

Echocardiogram is key diagnostic test. ECG may show LV hypertrophy and CXR cardiomegaly

Front 6

Module 4 - logbook 2: pathophysiology

Back 6

Stenosis raises pressure leading to LVH. Eventually pressure increases and is backed up into lungs. CO drops and heart failure ensues

Front 7

Module 4 - logbook 2: anatomy

Back 7

Valves of the heart: L - aortic, mitral. R - pulmonary and tricuspid

Front 8

Module 4 - logbook 2: prognosis

Back 8

With symptoms 15-50% survival at 5 years. Much better with surgery

Front 9

Module 4 - logbook 2: management

Back 9

Manage risk of IHD and monitor. Sypmtomatic >>> surgery. 1. Aortic valve replacement. 2. Balloon valvuloplasty. 3. Transcatheter aortic valve implantation (TAVI - blend of two)

Front 10

Module 4 - logbook 1: drugs - ASPIRIN

Back 10

Antiplatelet - Acetyl donor to COX rendering it inactive which reduces thromboxane A2

Front 11

Module 4 - logbook 2: drugs - AMITRIPTYLINE

Back 11

Tricyclic antidepressant - inhibits reuptake of norepinephrine + serotonin

Front 12

Module 4 - logbook 2: drugs - RAMIPRIL

Back 12

Hypertension - ACE inhibitor: stops ATI converting to ATII. ATII is a potent vasdoilator. Dry cough. Monitor renal function eGFR

Front 13

Module 4 - logbook 2: drugs - SIMVASTATIN

Back 13

Hypercholesterolemia - enzyme inhibitor HMG coA reductase, reducing quantity of mevalinic acid, a precursor of cholesterol

Front 14

Module 4 - logbook 2: drugs - BISOPROLOL

Back 14

MI prophylaxis - beta blocker - blocks beta 1 receptors reducing sympathetic stimulation

Front 15

Module 4 - logbook 2: eitology

Back 15

Degenerative calcific aortic stenosis, congenital (unicuspid or bicuspid valve) or rheumatic fever