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Definition
Aortic Stenosis
- Aortic Stenosis – Is the narrowing of the orifice
between the left ventricle and the aorta
- The obstruction to the aorta outflow put a pressure
load on the left ventricle resulting into hypertrophy and failure
Causes of aortic Stenosis
- Rheumatic fever
- Arteriosclerosis
- Congenital
Clinical features
- Exertional, dysponea and fatigue
- Dizziness and fainting because of reduced volume of
blood going to the brain
- Angina pectoris due to increased Oxygen demands
- Low B/P and low pulse pressure from diminished blood
flow (30mmHg or less)
- Dysrhythmias
- Symptoms of heart failure
- In physical examination laud, rough systolic murmur
heard over the aortic area
Diagnostic evaluation
1.
Chest X-ray – show left ventricle enlargement
2.
Physical examination
3.
Cardiac catheterization- Will reveal pressure in the
left ventricle and aorta
4.
Angiocardiagraphy- Will reveal pressure in the left ventricle and
aorta
5.
Echocardiography-
Will reveal pressure in the left ventricle and aorta
6.
ECG
Treatment
- Surgical replacement of aortic valve – prosthetic
device or aortic valve homograft
- Treat angina and heart failure
Definition of Aortic incompetence
- Aortic incompetence (regurgitation) is caused by an
inflammatory lesion that deforms the flaps so that they fail to seal the
aortic orifice, during diastole thus permitting a back flow of blood from
the aorta into the left ventricle.
Causes Aortic
incompetence
- Rheumatic endocarditis
- Bacterial endocarditis
- Congenital malformation
- Syphilis disease
- Rheumatoid spondylitis
- Dissecting aneurysm
Step 9: Clinical features (signs and symptoms)
- Exertional dyspnoea and fatique
- Insidious onset
- Increased force of heart beat
- Palpable arterial pulsation over the precardium and
neck
- Signs of left ventricular failure
- Chest pain
- Palpitations
- Diastolic murmur
- Symptoms of heart failure
Diagnostic evolution
- ECG left ventricular hypertrophy
- Chest X-ray -
shows Cardiomegally
- Echocardiography – estimates size and thickness of
left ventricle
- Cardiac catheterization and angiography
Treatment
- Surgical intervention – Replacement of damaged aortic
valve is the treatment of choice
- If patient has signs of congestive heart failure
medical management is recommended until surgery can be performed.
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