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Cards In This Set
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List AS Etiology
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Calific / degenerative
50% bicuspid Rhumatic (assocaed with MS) (thick vales) Congenital (bicuspid 1-2%) Supra valve dysfunction Rhumatic Fever post inflamatoy |
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Lise AS Pathophysiology
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Sysotolic pressure overload leads to LVH (increased in afterload) __Increased LVEDP- increased LA size______ Ventricular dysfunction may develop late in the dsease course._____Increased risk or edocardiis_____Aortic sclerosis occurs when there is valvular thickeng but no hemodynamic gradient
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List physical signs of AS
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Angina-
Dyspnea- Syncope- Sudden Death- Harsh sytolice ejection murmur (RUSB) crescendo-decrescento Decreased or absent A2 (valve doesn't move) Decreased a delye caroticupstroke with bruit / thrill tramitted from AoV Harvis Parvis (weak plse) |
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Echo of AS |
 Thickened aortic leaflets----------Decreased valve opening--------------Post-stenotic dilatation of the aorta - thought to be caused by abnornal turbulence and wall stress (remember there is low pressure in the aorta (systolis BP) but high pressure in the LV)-------------LVH |
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Normal velocity for AS is
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200 cm/sec
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What are the symptoms of severe AS
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Angina___Dyspnea ____Syncope___Sudden Death____Shortness of Breath
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A secondary finding of AS is
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LA enlargement____ LV enlargment____LVH____ Increased afterload
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In AS is the pulse pressure wide or narrow
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Narrow
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What is the cut off for severe AS
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<1
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What is the cut off for Aortic jet velocity for severe AS
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>4
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What is the Etiology of Mitral Stenosis
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Rheumatic (commissarial fusion most common)_______Congenital (parachute rare)_____Acquired (MAC)_____Prosthetic valve dysfunction
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What is the pathophysiology of MS
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Diffuse leaflet thickening, scarring, contraction, commissural fusion and chordae shortening and fusion.----------Associated mitral regurgitation may be present-------Increased left atrial pressure causes LA dilatation--------Long standing obstruction leads to pulmonmary hypertension (RV & RA enlargement)---------Decrease in cardiac output---------Acute rheumatic fever: beta hemolytic strep, polyarthritis, fever, subcutaneous nodules, carditis and a rash (45% develop MS)------Increased risk for endocarditis.
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Physical signs of MS
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Diastolic murmur (rumble) with opening snap-----Atrial fibrillation is common-----------CHF symptoms (dyspnea, fatigue, orthopnea, peripheral edema)------Hemoptysis (bloody sputim).
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ECHO of MS
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Thickened MV leaflets with decreased mobility------- Tethered MV leaflet tips ("hockey stick" presentation----Left atrial enlargement-----Signs of pulmonary hypertenson in advaced disease-----Planimeter valve are in parasternl SAX view-----RV and RA enlargemet.
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 M-Mode of MS |
1. Decreaed E-F slope-----2. Anterior motion f the posterior leaflet-----3. Reduced amplitude of the E wave-----4. Multiple echos
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