AORTIC STENOSIS 

 
Hemodynamics

Symptoms: Asymptomatic until stenosis is very severe (e.g. 0.5cm2/m2body surface area in adults). Exertion dyspnea, angina pectoris, syncope, fatigue.
Special signs: Pulsus parvus et tardus, bisferiens pulse, Giant "a" waves, left ventricular hypertrophy, mid-systolic ejection click
Special investigations: ECG shows left ventricular hypertrophy. In advance cases ST segment depression ; T wave inversion in leads I, and aVL. Xray shows post stenotic dilatation of ascending aorta and left ventricular enlargement and pulmonary congestion in late cases.

SHORT DESCRIPTION:
Disease may be congenital or due to rheumatic carditis. It may also be due to degenerative calcification. They all cause obstruction to left ventricular outflow and are therefore associated with other conditions that cause the same- hypertrophic cardiomyopathy, discrete congenital subvalvular aortic stenosis and supravalvular aortic stenosis.

 

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