- exertional dyspnoea
- etertional angina
- exertional dizziness
Signs of aortic stenosis include:
- ejection systolic murmur radiating to carotids
- slow rising pulse
- narrow pulse pressure
- heaving apex beat
Things which suggest severe aortic stenosis include:
- LVF
- soft S2
- paradoxically split A2
- S4
The formal divisions of severity are as follows:
- mild: area >1.5cm, gradient <25
- moderate: area 1-1.5cm, gradient 25-50
- severe: area <1cm, gradient >50
- critical: area <0.7cm, gradient >80
The main causes of aortic stenosis are:
- calcification of the valve
- bicuspid aortic valve
ECG changes which may be associated with aortic stenosis include:
- p mitrale
- LVH
- LAD
- poor R wave progression
- complete heart block if calcification involves the conduction tissue.
Treatment is surgical. The operative mortality is around 20-25% if there is LVF, 2-8% if not.
So from the very factual aortic stenosis on to the slightly touchy-feeling PMR...
