Aortic Stenosis

Etiology

  • Obstruction in flow from ventricle to aorta due to failure of valve leaflets to open appropriately
  • Can occur due to calcification of normal tri-leaflet valve (senile calcific) or from calcification of congenital bicuspid valve

Risk Factors

  • Adult calcific (tri-leaflet) age >70
  • Bicuspid age > 40
  • Rheumatic heart disease

Symptoms

  • Initially asx, then can have SOB, syncope, chest pain, chf as stenosis worsens

Physical Exam Findings

  • Crescendo-descrendo systolic murmur
  • Loudest upper sternal borders, though often audible across precordium
  • Radiates to carotids and R clavicle
  • Later peaking as progresses
  • With severe disease, loss of A2
  • CHF findings can occur in advanced disease

Tests

Links