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Aortic Stenosis (IX (ECG (LVH, Arrhthmias), CXR ( Calcified AV  LVH …

- - - - Echo Features of Severe AS (AHA 2006)
        
         Valve area <1cm2  Pressure gradient >40mmHg
         Jet velocity >4m/s
- - - -  Quiet A2
      -  Early syst. ejection click if pliable (young) valve
      -  S4 (forceful A contraction vs. hypertrophied V)
    - -  ESM
      -  Right 2nd ICS
      -  Sitting forward in end-expiration
      -  Radiates to carotids
- - - - Optimise CV risk: statins, anti-HTN, DM, anti
  - - - Symptomatic AS
         Severe asymptomatic AS c¯ ↓ EF (<50%)
         Severe AS undergoing CABG or other
- - - - Angina: 50% dead in 5yrs
      - Syncope: 50% dead in 3yrs
      - Dyspnoea: 50% dead in 2yrs