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Aortic Stenosis (Epidemiology (Types (Supravalvular e.g. congenital…
Aortic Stenosis
Epidemiology
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Types
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Subvalvular e.g. congenital condition in which a fibrous ridge or diaphragm is situated immediately below the aortic valve
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Clinical Presentation
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Classic symptoms: syncope, angina, heart failure, dyspnoea on exertion due to heart failure
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Think aortic stenosis in ANY elderly person with chest pain, exertion dyspnoea or syncope (loss of conscious due to lack of blood)
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Main Causes
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Calcific aortic valvular disease (CAVD) - essentially calcification of the aortic valve resulting in stenosis, most commonly seen in elderly
Pathophysiology
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A compensatory mechanism ensues, which leads to exhausted left ventricular function as hypertrophy requires increased blood demand
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Diagnosis
ECG - left ventricular hypertrophy, left atrial delay, left ventricular 'strain' pattern
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Echocardiogram - left ventricular hypertrophy, dilation and ejection fraction.
Risk Factors
Congenital bicuspid aortic valve (BAV) predisposes to stenosis and regurgitation - bicuspid valves are more likely to develop stenosis
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Key Facts
Narrowing of the aortic valve resulting in obstruction to the left ventricular stroke volume, leading to symptoms of chest pain, breathlessness, syncope and fatigue