Dr. Emily Nguyen, MD, PhD

Mentor: Milena Gebska, MD, PhD

Aortic Stenosis

Definition: Valvular aortic stenosis is a progressive disease in which the end stage is characterized by obstruction of left ventricular outflow, resulting in inadequate cardiac output, decreased exercise capacity, heart failure, and death from cardiovascular causes.

Typical Symptoms:

* Angina

* Dyspnea on exertion

* Syncope

* Heart Failure

Risk Factors:

* Hypertension

* Diabetes

* Dyslipidemia

* AGE – 9.8% in octogenarians

Severe AS can be diagnosed on physical exam:

* Typical systolic ejection murmur at the base radiating to the neck

* Usually peaks in early- or mid-systole

* Carotid pulse is delayed “parvus et tardus”

* Absent or soft S2

Transcatheter Aortic Valve Replacement:

* Non-invasive intervention for valve replacement

* Adverse events include: conduction abnormalities (LBBB, heart block), stroke, vascular complications, acute renal failure, paravalvular leak

References:

1. Otto CM, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021 Feb 2;143(5):e72-e227. doi: 10.1161/CIR.0000000000000923. PMID: 33332150.

2. Ross J Jr, Braunwald E. Aortic stenosis. Circulation. 1968 Jul;38(1 Suppl):61-7. doi: 10.1161/01.cir.38.1s5.v-61. PMID: 4894151.