AORTIC VALVE STENOSIS
This clinical condition causes blockage or obstruction to the outflow of the left ventricle. To maintain the normal cardiac output, left ventricle becomes hypertrophied though it will still cause low cardiac output and coronary blood flow becomes inadequate. During exercise, the left ventricle is unable to meet oxygen demands of body and myocardium which leads to angina, left ventricular failure, arrhythmias and when left ventricular failure develops, it causes resistance to flow of blood from left atrium to left ventricle resulting in rising in left atrial pressure that leads to left heart failure.
Causes:
- CONGENITAL: in infants, children, and adolescents.
- Valvular
- Subvalvular
- Supravalvular
- Adults:
- Congenital due to calcific bicuspid valve , fibrotic bicuspid valve
- Rheumatic
- Senile degenerative aortic stenosis in older patients.
Symptoms:
- Asymptomatic for long periods
- Exertional dyspnoea
- Angina pectoris
- Cough, hemoptysis, dyspnoea, orthopnoea
- Exertional syncope
- Sudden death
- Ankle edema
- Jugular venous pressure is raised.
Diagnosis:
- Electrocardiogram
- Chest X-ray
- Echocardiography
- Doppler echocardiography
Treatment:
- MEDICATIONS: Long term antibiotics prophylaxis is given to patients In old age where heart failure can develop if it develops diuretics and vasodilators are given and anticoagulants in patients who have undergone valve replacement.
- BALLON VALVULOPLSTY: done in congenital noncalcific aortic stenosis.
- VALVE REPLACEMENT: is the most effective treatment to prevent any sudden death and it is done in patients with symptomatic patients with normal cardiac output and pressure gradient>60mm across the valve.