Aortic Valve Disease_Illustrative Cases

Posted by e-Medical PPT
Understand the use of echocardiography to assess aortic valve disease
Apply clinical guidelines to management of aortic valve disease

Selected Abnormalities of Aortic Valve
Aortic Stenosis
– Narrowing of the valve orifice
Aortic Regurgitation
– Incompetence of the valve
– Blood “leaks” from aorta to left ventricle in
ventricular diastole
Bicuspid Aortic Valve
Endocarditis

Why do aortic valves become stenotic?
Valvular Stenosis
– Bicuspid valve with calcification
– Age-related calcific aortic stenosis
– Rheumatic
– Rare causes: Congenital, Rheumatoid, Severe
atherosclerosis (Hyperlipidemia), alkaptonuria
Supravalvular Stenosis
Subvalvular Stenosis
– Discrete
– Hypertrophic Cardiomyopathy

Case 1
77 year old African American Male Referred for evaluation of murmur
Medical history: HTN
Asymptomatic, able to walk up and down stairs, shovel snow
BP 146/86
Crescendo/Descrescendo 3/6 systolic murmur at left lower sternal border

Pathphysiology of Aortic Stenosis
Previously felt to occur as a normal process of aging, related to mechnical stress on normal valve
Current theory involves inflammatory process with T lymphocyte and macrophage infiltration with lipid
accumulation, resulting in bone formation(calcification)

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