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Aortic Stenosis

Source: www.med.unc.edu
Topic: Aortic stenosis
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Sort Desciption: Aortic Stenosis 1. Trileaflet with calcific degeneration - same process as atherscolerosis? Most aortic systolic murmurs in the elderly are aortic sclerosis, which may progress to ...

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Aortic Stenosis 1. Trileaflet with calcific degeneration same process as atherscolerosis? Most aortic systolic murmurs in the elderly are aortic sclerosis, which may progress to stenosis but does not imply stenosis 2. Congenitally bicuspid May be associated with dilation of the aortic root or with coarctation of the aorta 3. Rheumatic Heart Disease Most common mitral valve only Next most common mitral and aortic valve involvement Least common aortic valve only Patients may have a period of 20-30 years without symptoms. Thus, the patients with congenital bicuspid valve may develop symptoms at age 30 or 40, while the elderly patient with atherosclerosis and aortic sclerosis may develop symptoms at age 70 or 80. When to replace the valve? Symptoms (Angina 5 years, Syncope 3 years, Heart Failure 2 years) What about patients with severely depressed LV function (LVEF 15-20%) and true aortic stenosis? Higher operative mortality, but surgery still indicated. What about patients with severe AS by echo, but asymptomatic? 66-75% will need replacement for symptoms within 5 years regular echo surveillance, q 1 year Are asymptomatic patients with severe AS at risk for sudden cardiac death? 1% per year Should asymptomatic patients with severe AS be stressed in attempt to identify those at highest risk? Probably not Aortic Insufficiency (chronic) 1. Leaflet Problems Bicuspid valve, IE, RF, SLE, RA, ankylosing ...

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