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Aortic Stenosis:
- Aortic VALVE LEAFLETS become STIFF, FUSED, or CALCIFIED.
- IMPEDE FLOW from LV into the AORTA during VENTRICULAR SYSTOLE
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Aortic Stenosis: Caused By
- congenital malformation
- inflammatory heart disease (ENDOCARDITIS)
- Calcification
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Aortic Stenosis: Pathyphysiology
- AORTIC VALVE NARROWS
- obstructs flow into aorta during SYSTOLE
- INCREASED LV pressure
- LV HYPERTROPHY
- cardiac output fixed
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Aortic Stenosis: Causes
<30 congenital stenosis
30-65 progressive stenosis
>65 degeneration/sclerosis of valve
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Aortic Stenosis: Diet
- UNRESTRICTED
- unless heart failure is present
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Aortic Stenosis: Diagnostic testing
- ECG
- :late stages will reveal left ventricular hypertrophy, nonspecific ST depression,
- T wave inversion that indicates subendocardial ischemia
Chest x-ray:aortic calcification
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Aortic Stenosis: Assessment
- Early symptoms: fatigue and dyspnea
- dyspnea,
- exertional angina ,
- syncope or near-syncopal episodes
- indicates severe aortic stenosis
- Individuals who develop symptomatic heart failure survive less than 2 years
- The hallmark clinical findings:A grade III/VI or IV/VI systolic ejection murmur
- over the aortic area radiating upward into the carotid arteries and a pulse pattern
- that demonstrates a delayed systolic upstroke
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Aortic Stenosis: MURMUR
SYSTOLIC MURMUR BETWEEN S1-S2
crescendo-decrescendo
- S2 CLOSES WEAK, SOFT SOUNDING
- Right Upper sternal border radiates to carotids
- Carotid pulses are weak and delayed:
- SYNCOPE, DIZZINESS
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