Aortic stenosis - stiffening, narrowing
Pressure overload - high resistance low reps → hypertrophy
Causes/Factors
- Congenital: bicuspid aortic value
- Calcification of the valve causing narrowing
- Age 65+
Symptoms
Syncope Angina Dyspnoea - on exercise
Signs
- Hard and loud ejection systolic murmur Between S1 and S2
- Reduced pulse pressure (difference between systolic and diastolic)
- Forceful apex beat
Diagnostic Tests
- Echocardiogram - left hypertrophy with poor valve movement possible regurgitation
- ECG - poor R wave progression and stuff which I don’t understand yet
Management
If pressure difference between ventricle and aorta remains below 60 mmHg the patient is kept under observation
- If ventricle starts to dilate valve replacement is considered
- Valve replacement is either via open heart surgery or via Transcatheter aortic valve implantation (TAVI)
- TAVI is going to be standard in future esp for older people